Renal pathological analysis using galactose-deficient IgA1-specific monoclonal antibody is a strong tool for differentiation of primary IgA nephropathy from secondary IgA nephropathy.

CEN Case Reports
Mingfeng LeeYusuke Suzuki

Abstract

In several cases with IgA nephropathy (IgAN), differential diagnosis is difficult due to the complication with other systemic diseases which can induce secondary IgAN. Recently, we demonstrated that immunostaining with galactose-deficient IgA1-specific monoclonal antibody (KM55 mAb) specifically showed positive in primary IgAN cases. Here, we report four cases which we could make definitive diagnosis by immunohistological analysis using KM55 mAb. The underlying systemic diseases are rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), hepatitis C (HCV) and Crohn's disease (CD). Renal pathological findings in the four cases revealed mesangial proliferative glomerulonephritis with IgA and C3 deposits. Immunostaining with KM55 mAb was positive for three cases complicated with RA, SLE and CD, respectively. Thus, these three cases were diagnosed as primary IgAN and treated with tonsillectomy and steroid pulse therapy. These three cases finally achieved clinical remission. On the other hand, the case with HCV showed negative for KM55. Finally, we diagnosed as HCV-related nephropathy and successfully treated by antiviral agents. These cases suggested KM55 mAb is a strong tool to differentiate primary IgAN from secondary IgAN.

References

Mar 22, 2012·Seminars in Immunopathology·Jan NovakMatthew B Renfrow
Aug 6, 2013·Clinical and Experimental Nephrology·Yusuke SuzukiSeiichi Matsuo
Jan 9, 2014·The Journal of Biological Chemistry·Hitoshi SuzukiJan Novak
Jun 26, 2015·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Junichi YasutakeYasuhiko Tomino
Oct 11, 2016·International Urology and Nephrology·Jiayu DuanZhangzuo Liu
May 10, 2018·Clinical and Experimental Nephrology·Hitoshi Suzuki
May 29, 2018·Kidney International·Manish K SahaDana V Rizk

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Citations

Apr 19, 2021·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Johannes MünchJan Halbritter

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Methods Mentioned

BETA
biopsy
enzyme-linked immunosorbent assay

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