Please use this identifier to cite or link to this item: https://repository.monashhealth.org/monashhealthjspui/handle/1/32138
Title: Histological differences in new-onset IgA nephropathy between children and adults.
Authors: Narita I.;Uchiyama M.;Ueno M.;Kawachi H.;Nikolic-Paterson D.J. ;Shimizu F.;Ikezumi Y.;Suzuki T.;Imai N.
Institution: (Ikezumi, Suzuki, Uchiyama) Department of Pediatrics, Niigata University Medical and Dental Hospital, Asahimachi-dori, Niigata 951-8510, Japan (Imai, Ueno, Narita) Division of Clinical Nephrology and Rheumatology, Institute of Nephrology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan (Kawachi, Shimizu) Department of Cell Biology, Institute of Nephrology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan (Nikolic-Paterson) Department of Nephrology, Monash Medical Centre, Clayton, VIC, Australia (Nikolic-Paterson) Monash University, Department of Medicine, Monash Medical Centre, Clayton, VIC, Australia
Issue Date: 18-Oct-2012
Copyright year: 2006
Publisher: Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United Kingdom)
Place of publication: United Kingdom
Publication information: Nephrology Dialysis Transplantation. 21 (12) (pp 3466-3474), 2006. Date of Publication: 01 Dec 2006.
Abstract: Background. It is suggested that IgA nephropathy (IgAN) manifests differently in children vs adults on the basis of biopsy findings. However, this has been difficult to establish owing to the uncertainty of the timing of disease onset in adult IgAN. We addressed this question by comparing both histology and leucocyte accumulation in biopsies of recently diagnosed childhood and adult IgAN. Methods. Biopsies taken within 2 years from the onset of renal abnormalities in 33 childhood (10 +/- 3 years of age) and 38 adult (35 +/- 6 years) cases of IgAN were examined for histological changes (cellularity in mesangial, endocapillary and extracapillary areas, matrix expansion, adhesions/crescents and interstitial damage), glomerular deposition of immunoglobulin and complement, and the presence of macrophages, activated macrophages and T cells by immunohistochemistry. Results. Glomerular hypercellularity owing to increased cells in mesangial area was prominent in paediatric IgAN and significantly greater than in adult IgAN. In contrast, glomerular matrix expansion, crescent formation and interstitial damage were more severe in adults compared to paediatric IgAN. Indeed, glomerular hypercellularity correlated with proteinuria in paediatric but not in adult IgAN, whereas glomerular matrix correlated with proteinuria and renal function in adult but not in paediatric IgAN. The degree of C3c deposition was significantly greater in paediatric IgAN, while deposition of fibrinogen was greater in adult IgAN. Glomerular and interstitial CD68+ macrophages and a subset of sialoadhesin (Sn)+ activated macrophages were identified in both paediatric and adult IgAN, being significantly greater in number in adult IgAN. Glomerular leucocyte infiltration correlated with proteinuria while interstitial leucocyte infiltration correlated with interstitial damage in both groups. However, only the subset of Sn+ macrophages gave a significant correlation with renal function, glomerular hypercellularity and glomerular matrix. Conclusions. This study has demonstrated significant differences in the early glomerular lesions of IgAN in children vs adults. Furthermore, Sn+ activated macrophages are implicated in the pathogenesis of IgAN in both patient groups. The prognostic significance of these findings warrants further study. © Copyright 2006 Oxford University Press.
DOI: http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1093/ndt/gfl455
PubMed URL: 16935895 [http://www.ncbi.nlm.nih.gov/pubmed/?term=16935895]
ISSN: 0931-0509
URI: https://repository.monashhealth.org/monashhealthjspui/handle/1/32138
Type: Article
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