Complement-mediated microangiopathy in IgA nephropathy and IgA vasculitis with nephritis
| Autor: | Jan A. Bruijn, Hans J. Baelde, Johan W. de Fijter, Malu Zandbergen, Ron Wolterbeek, Leendert A. van Es, Ingeborg M. Bajema, Jamie S. Chua |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Vasculitis 0301 basic medicine medicine.medical_specialty Pathology Renal function Complement Membrane Attack Complex Complement factor I Kidney Gastroenterology Pathology and Forensic Medicine Nephropathy Young Adult 03 medical and health sciences 0302 clinical medicine Internal medicine Complement C4b medicine Humans Complement Activation Retrospective Studies Nephritis Thrombotic Microangiopathies business.industry Microangiopathy Glomerulonephritis IGA Glomerulonephritis Retrospective cohort study Middle Aged Prognosis medicine.disease Peptide Fragments Immunoglobulin A 030104 developmental biology IgA vasculitis 030220 oncology & carcinogenesis Disease Progression Female business |
| Zdroj: | Modern Pathology, 32(8), 1147-1157 |
| ISSN: | 0893-3952 |
| Popis: | Complement factor C4d was recently observed in renal biopsies from patients who had IgA nephropathy and a poor prognosis. We previously reported that C4d is a common denominator in microangiopathies. In this retrospective cohort study, we investigated whether C4d is a marker of microangiopathy in both IgA nephropathy and IgA vasculitis with nephritis, and whether patients with C4d and microangiopathy have poor renal outcome. We examined 128 renal biopsies from adult and pediatric patients, including normotensive and hypertensive patients, who presented with IgA nephropathy or IgA vasculitis with nephritis. Biopsies were re-evaluated in accordance with the Oxford classification, scored for additional lesions, and stained for complement proteins using immunohistochemistry, including C4d and C5b-9. Clinical data were collected with a mean (±SD) follow-up period of 51 ± 39 months. Changes in estimated glomerular filtration rate over time were compared using linear mixed-effects models. Renal survival was analyzed using multivariable Cox regression. Microangiopathic lesions were present in 20% of all biopsies (23% and 9% of patients with IgA nephropathy and IgA vasculitis with nephritis, respectively). Microangiopathy was associated with C4d and C5b-9 deposits, a higher number of chronic lesions, and hypertension (all p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink