Monoclonal and polyclonal immunoglobulin G deposits on tubular basement membranes of native and pretransplant kidneys: A retrospective study

Autor:	Junki Koike, Yoji Nagashima, Kazuho Honda, Akira Shimizu, Hideki Ishida, Kazunari Tanabe, Tomomi Tamura, Sekiko Taneda, Motoshi Hattori, Kosaku Nitta, Anri Sawada, Shigeru Horita, Masayoshi Okumi
Rok vydání:	2021
Předmět:	Male 0301 basic medicine Pathology medicine.medical_specialty Biopsy Lupus nephritis Kidney Basement Membrane Immunoglobulin G Pathology and Forensic Medicine Diabetic nephropathy 03 medical and health sciences 0302 clinical medicine Focal segmental glomerulosclerosis Humans Medicine Retrospective Studies biology business.industry General Medicine medicine.disease Kidney Transplantation 030104 developmental biology Renal pathology Polyclonal antibodies 030220 oncology & carcinogenesis Monoclonal biology.protein Female business Monoclonal gammopathy of undetermined significance
Zdroj:	Pathology International. 71:406-414
ISSN:	1440-1827 1320-5463
Popis:	BackgroundMonoclonal tubular basement membrane immune deposits (TBMID) are identified by renal biopsy and are associated with progression of interstitial injury in renal allograft. However, the significance of TBMID in the native kidney remains unclear.MethodWe retrospectively analyzed 3,126 native kidney biopsies and 1,724 zero-hour biopsies performed between 2008 and 2018 in our institution.ResultsThe rate of immunoglobulin G (IgG) TBMID was found to be 5.2 % among native kidney biopsies and 0.4 % among zero-hour biopsies. The rate of IgG TBMID was relatively common in the case of diabetic nephropathy (31.3%) and lupus nephritis (25.5%), but rare in IgA nephropathy (IgAN) (1.1%). Monoclonal IgG TBMID was identified in seven cases, including three zero-hour biopsies. The pathological diagnosis from native kidney biopsy was IgAN in two cases, antineutrophil cytoplasmic antibody-related vasculitis in one, and Focal segmental glomerulosclerosis in one. Zero-hour biopsy revealed IgAN in one case and mild atherosclerosis in two. The combination of IgG1κ was observed in two cases, IgG1λ in three, and IgG2κ in two. Interstitial injury is not severe in all cases. Electron microscopy revealed powdery electron-dense deposits. Monoclonal gammopathy of undetermined significance was diagnosed in one case with IgA nephropathy. Although One patient developed renal failure, all others exhibited stable renal function.ConclusionMonoclonal IgG TBMID in the native kidney is not associated with renal prognosis or interstitial injury. However, this could be a useful immunopathological parameter for early identification of cases requiring hematological investigation and microscopic evaluation.
Databáze:	OpenAIRE
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