Characterization of IgA Deposition in the Kidney of Patients with IgA Nephropathy and Minimal Change
| Autor: | Ju Young Moon, Won Hee Cho, Yang Gyun Kim, Kyung Hwan Jeong, Seul Ki Choi, Bum Soon Choi, Sung Jig Lim, Sang-Ho Lee, Su Woong Jung, Seon Hwa Park, Jong Hyun Jhee, Ho Jun Chin, Ji Youn Sung |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
030232 urology & nephrology Lupus nephritis lcsh:Medicine 030204 cardiovascular system & hematology urologic and male genital diseases Gastroenterology Article Nephropathy 03 medical and health sciences 0302 clinical medicine Glomerulopathy Internal medicine medicine Minimal change disease double immunofluorescent staining Kidney business.industry nephrotic syndrome IgA nephropathy with minimal change disease lcsh:R galactose-deficient IgA1 nutritional and metabolic diseases Glomerulonephritis General Medicine medicine.disease eye diseases medicine.anatomical_structure business Nephrotic syndrome KM55 Cohort study |
| Zdroj: | Journal of Clinical Medicine Volume 9 Issue 8 Journal of Clinical Medicine, Vol 9, Iss 2619, p 2619 (2020) |
| ISSN: | 2077-0383 |
| DOI: | 10.3390/jcm9082619 |
| Popis: | Approximately 5% of patients with IgA nephropathy (IgAN) exhibit mild mesangial lesions with acute onset nephrotic syndrome and diffuse foot process effacement representative of minimal change disease (MCD). It is not clear whether these unusual cases of IgAN with MCD (IgAN-MCD) are variant types of IgAN or coincidental deposition of IgA in patients with MCD. In a retrospective multicenter cohort study of 18 hospitals in Korea, we analyzed 46 patients with IgAN-MCD. Patients with endocapillary proliferation, segmental sclerosis, and crescent were excluded, and the clinical features and prognosis of IgAN-MCD were compared with those of pure MCD. In addition, we performed galactose-deficient IgA1 (KM55) staining to characterize IgAN-MCD. Among the 21,697 patients with glomerulonephritis enrolled in the database, 46 patients (0.21%) were diagnosed with IgAN-MCD, and 1610 patients (7.4%) with pure MCD. The 46 patients with IgAN-MCD accounted for 0.6% of primary IgAN patients (n = 7584). There was no difference in prognosis between patients with IgAN-MCD and those with only MCD. IgA and KM55 showed double positivity in all patients with IgAN-MCD (n = 4) or primary IgAN (n = 5) under double immunofluorescent staining. However, in four patients with lupus nephritis, mesangial IgA was deposited, but galactose-deficient-IgA1 (Gd-IgA1) was not. These findings suggest that IgAN-MCD is a dual glomerulopathy in which MCD was superimposed on possibly indolent IgAN. We confirmed by KM55 staining that IgAN-MCD is true IgAN, enabling better characterizations of the disease. Furthermore, IgAN-MCD shows a good prognosis when treated according to the usual MCD treatment modality. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
| Nepřihlášeným uživatelům se plný text nezobrazuje | K zobrazení výsledku je třeba se přihlásit. |