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Abstract: SA-PO413

Characterization of Lymphocytic Interstitial Infiltrate in ANCA GN

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Kant, Sam, University of Maryland, Baltimore, Maryland, United States
  • Arend, Lois J., Johns Hopkins Hospital, Baltimore, Maryland, United States
  • Gapud, Eric J., Johns Hopkins School of Medicine, Baltimore, Maryland, United States
  • Geetha, Duvuru, John Hopkins Bayview Medical Center, Baltimore, Maryland, United States
Background

B &T cells have a pathogenic role in ANCA associated vasculitis. There are differences in renal outcome based on ANCA type, therefore, we sought to characterize the interstitial lymphocytic infiltrate in ANCA GN to determine differences in relation to ANCA type and entry GFR.

Methods

Renal biopsies of patients with ANCA GN were stained for CD3, CD4, CD20, C4d and FOXP3. The percentage of cortical interstitium containing positive cells was determined by light microscopy. Demographics, ANCA type and entry eGFR were recorded. The level of staining was compared between ANCA type and entry eGFR using Wilcoxon rank sum test.

Results

Renal biopsies of 16 patients with MPO and 14 with PR3 ANCA GN were studied. CD3 cells were the predominant cells, with CD4 and FOXP3 staining positive in all biopsies. C4d staining was negative in all biopsies. There was no significant difference in staining between MPO and PR3 groups. However, regardless of ANCA type, FOXP3 staining was significantly higher in patients with baseline GFR<10 compared with GFR>10 (mean 7.54, SD 6.6 versus mean 2.67, SD 3.6; p=0.04). Image 1 demonstrates scatter plots of mean percentage of interstitial staining for markers and entry GFR(blgfr) in MPO and PR3 subsets.

Conclusion

These data confirm the role of CD4 cells in ANCA GN and demonstrate no differences in interstitial T and B cell infiltrates between PR3 and MPO ANCA GN. A higher FOXP3 signal suggests a role for regulatory T cells and merits further characterization of CD4 T cell subset.