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Abstract: PO1547

Clinical-Pathological Features of Podocyte Infolding Glomerulopathy

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Hong, Ling, Department of Nephrology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
  • Wang, Lin, Department of Renal Pathology, Guangzhou Kingmed Diagnostic Laboratory Ltd, Guangzhou, Guangdong, China
  • Zheng, Zhihua, Department of Nephrology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
  • Chen, Wenfang, Department of Pathology,The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
Background

Podocyte infolding glomerulopathy (PIG) is characterized by presence of microstructural aggregates originated from cytoplasmic infoldings of podocytes in the glomerular basement membrane (GBM). Few PIG cases have been reported and the significance of this morphology is still unclear. This study aims to elucidate the incidence, clinical-pathological features and prognosis of PIG.

Methods

Renal biopsies with PIG features from January 2018 to December 2020 in Kingmed Diagnostic Laboratory were reviewed. Patients were divided into three groups according to their clinical and pathological findings.

Results

Among 87452 biopsies, 116 (1.37‰) cases were found to have features of PIG and 61 patients among them had complete clinical data and follow-up information. Most PIG cases were accompanied with other glomerular diseases, among which were 39 cases (63.9%) with lupus nephritis (Group PIG-LN), 14 cases (23%) with other glomerulonephritis such as membranous nephropathy, focal segmental glomerulosclerosis (FSGS) and IgA nephropathy (Group PIG-GN). Only 8 cases (13.1%) presented with pure PIG with absence of immunoglobulins and complement deposits. In the PIG-LN group, most patients revealed presence of immunoglobulin deposits, with IgG in 84.6% of the patients, C3 in 74.4% and C1q in 69.2%. Similarly, electron dense deposits were seen in PIG-LN (61.5%) and PIG-GN (57.1%) in accordance with immunofluorescence. There is no significant difference in levels of proteinuria, hematuria and creatine among the three groups. Most patients in PIG-LN group showed increased ANA tier (100%) and decreased C3 level (84.6%).The patients in the pure PIG group showed more sensitivity to glucocorticoid therapy and got a significantly higher complete remission rate (75%) than those in group PIG-LN (53.8%) and group PIG-GN (14.3%).

Conclusion

PIG is a special type of podocyte injury, which is either a separate disease entity or concomitant with other GN, among which LN is the most frequent one. Patients with pure PIG tend to be more sensitive to glucocorticoid therapy compared with those coincide with other GN.

Different degree of PIG.