Clinicopathological characteristics of M-type phospholipase A2 receptor (PLA2R)-related membranous nephropathy in Japanese
| Autor: | Hitoshi Yokoyama, Hideki Yamaya, Yuki Matsui, Hiroki Adachi, Enyu Imai, Hiroshi Okuyama, Norifumi Hayashi, Seiichi Matsuo, Shinichi Akiyama, Shoichi Maruyama |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Nephrology Pathology medicine.medical_specialty Physiology Kidney Glomerulus Kaplan-Meier Estimate Glomerulonephritis Membranous Subclass Asian People Membranous nephropathy Antigen Physiology (medical) Internal medicine Biopsy medicine Humans Aged Retrospective Studies Proteinuria medicine.diagnostic_test biology business.industry Receptors Phospholipase A2 Middle Aged medicine.disease Staining Treatment Outcome Immunoglobulin G biology.protein Female medicine.symptom Antibody business Follow-Up Studies Glomerular Filtration Rate |
| Zdroj: | Clinical and Experimental Nephrology. 19:797-803 |
| ISSN: | 1437-7799 1342-1751 |
| Popis: | Recent studies have suggested that assessments of serum antibodies against M-type phospholipase A2 receptor (PLA2R) and the glomerular expression of PLA2R antigen in biopsy specimens are useful for the diagnosis of primary membranous nephropathy (MN). In this study, we assessed both of them and investigated the clinicopathological characteristics of PLA2R-related Japanese MN. We retrospectively enrolled 22 primary and 3 secondary Japanese patients whose serum samples and renal specimens were collected before treatment. According to the findings of serum antibodies and antigen in glomeruli, the primary MN patients were classified into PLA2R-related or -unrelated MN. We compared their clinicopathological findings, including IgG subclass staining, and electron microscopic findings, and evaluated the predictors of proteinuria remission. In primary MN, 16 patients (73 %) were classified into the PLA2R-related group, and 6 patients into the PLA2R-unrelated group. There was no significant difference in baseline laboratory data and electron microscopic findings, except for eGFR and serum IgG levels. IgG4-dominant deposition was more common in the related group (63 vs. 0 %). The 10 PLA2R-related patients with dominant IgG4 deposition had a lower rate and prolonged time in remission compared with the 6 PLA2R-related patients with non-dominant IgG4 (log-rank, p = 0.032). Furthermore, dominant IgG4 deposition was an unfavorable predictor of remission by multivariable Cox proportional hazard analysis. Assessments of both serum PLA2R antibodies and PLA2R antigen in glomeruli were more sensitive for the diagnosis of PLA2R-related MN, and among affected Japanese patients, those with dominant IgG4 deposition had worse clinical outcomes. |
| Databáze: | OpenAIRE |
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