IgA nephropathy: association of C4d with clinical and histopathological findings and possible role of IgM

Renal Failure
Cihan HeybeliTaner Camsari

Abstract

In patients with IgA nephropathy (IgAN) lectin and alternative pathways of the complement can be activated. Our aim was to analyze the association of glomerular and extraglomerular C4d staining--the representative of lectin pathway-with demographic, clinical and histopathological findings in primary IgAN patients. Seventy-three patients were enrolled and after re-evaluation 37 of them were included in this study. Biopsies were analyzed for staining with anti-C4d primary monoclonal antibody by immunohistochemistry. Patients were classified as positive and negative groups based on their glomerular C4d deposition. Groups were compared for their baseline clinical and histopathological findings. Sixteen (43.2%) of 37 patients were C4d-positive. Glomerular C4d-staining was associated with more severe proteinuria (2906 mg/day vs. 1091 mg/day; p = 0.002), lower GFR (54.87 mL/min vs. 95 mL/min; p = 0.023), higher blood pressure (p = 0.022), more severe endocapillary hypercellularity (p < 0.001) and more severe tubular atrophy (p < 0.01). Mesangial IgM deposition was found to be associated with glomerular C4d staining and nephrotic range proteinuria. Glomerular C4d deposition was found to be associated with more unfavorable histopatholog...Continue Reading

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Citations

Jul 15, 2016·Nephrology·Rafaela Cabral Gonçalves FabianoAna Cristina Simões E Silva
Feb 22, 2017·Current Opinion in Nephrology and Hypertension·Maria F Soares, Ian S D Roberts
Apr 28, 2016·Inflammatory Bowel Diseases·Cihan Heybeli
Apr 18, 2020·Virchows Archiv : an International Journal of Pathology·Hiroe ItamiChiho Ohbayashi
Feb 25, 2017·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Rafaela Cabral Gonçalves FabianoSérgio Veloso Brant Pinheiro
Oct 3, 2018·Fetal and Pediatric Pathology·Hee Sun BaekMin Hyun Cho
Jul 3, 2020·Journal of the American Society of Nephrology : JASN·Akiko TakahataYusuke Suzuki
Oct 8, 2018·Clinical and Experimental Nephrology·Cihan HeybeliTaner Çamsarı
Jun 27, 2019·Pediatrics International : Official Journal of the Japan Pediatric Society·Yasuyuki SatoTadashi Ariga
Jan 1, 2020·KI Reports·Cinthia B DrachenbergMario F Rubin

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