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Abstract: TH-PO808

Deposition of IgA and C3 on the Glomerular Loop Significantly Correlates with Urinary Protein in Immunoglobulin A Vasculitis with Nephritis (Henoch-Schonlein Purpura Nephritis)

Session Information

Category: Glomerular Diseases

  • 1202 Glomerular Diseases: Immunology and Inflammation

Authors

  • Karasawa, Kazunori, Department medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
  • Moriyama, Takahito, Department medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
  • Nitta, Kosaku, Department medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
Background

Immunoglobulin A vasculitis with nephritis (IgAVN) is considered to be systemic form of IgA nephropathy (IgAN). Both IgAN and IgAVN are defined by the presence of IgA dominant glomerular deposits. However, the pathological significance of the difference in glomerular location of IgA and other immunogrobulin deposits is remain unclear. In this study, we investigated which clinical findings and renal prognosis correlate with immunostaining findings in IgAVN.

Methods

We conducted a retrospective study of 33 adult patients of biopsy-proven IgAVN and analyzed these cases in terms of clinicopathological feature and renal prognosis. Especially, we evaluated renal biopsy specimens of IgAV in detail by immunostaining.

Results

33 adults IgAVN patients (male:21, female:12) were analyzed. Averege age was 41.12±14.7 years old at the renal biopsy. Localization of glomeruli of IgA, IgG, IgM as immunoglobulin, C3, C4d, C1q as complement factor, and fibrin, fibrinogen, kappa chain, lambda chain as others were examined by immunostaining. IgA deposition was observed on glomerular loop (capillary wall) of 10 patients (30%). The average proteinuria was 3.60±2.61 g/day in the IgA deposited on glomerular loop group and 1.53 ±1.63 g/day in the group with no IgA deposition on glomerular loop group. (P=0.0047) Furthermore, C3 deposition was also observed on glomerular loop of 10 patients (30%). The average urine protein was 4.04±2.64 g/day in the C3 deposited on glomerular loop group and 1.34±1.28 g/day in the group with no C3 deposition. (P<0.001) From these results, we revealed that the deposit of IgA and C3 on glomerular loop in immunostaining findings was positively correlated with the amount of the proteinuria. However, renal prognosis was no significant difference in both group in one year after treatment.

Conclusion

The deposition of IgA and C3 in the glomerular loop were significantly correlated with the amount of puroteinuria. These results suggested that these deposition may play a key role in the pathogenesis of IgAVN, and also suggested that the selection of therapy for IgAVN might be affected.