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儿童和成人 IgA 血管炎肾炎的肾脏组织病理学表现。

Renal histopathological manifestations of IgA vasculitis nephritis in children and adults.

机构信息

Department of Pediatrics, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China.

Department of Pediatrics, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China.

出版信息

Int Immunopharmacol. 2023 Mar;116:109760. doi: 10.1016/j.intimp.2023.109760. Epub 2023 Feb 8.

Abstract

BACKGROUND

IgA vasculitis nephritis (IgAVN) is a common form of secondary glomerulonephritis and can occur in patients of any age. Our study was designed to reveal renal histopathological manifestations of children and adults with IgAVN and to explore the potential pathogenesis of IgAVN.

METHODS

Sixty-one pediatric and seventy adult patients with IgAVN were enrolled altogether, and all of them underwent kidney biopsies. General information, laboratory parameters, and renal histopathological manifestations of all patients were analyzed.

RESULTS

(1) Diabetes, hypertension, and various levels of proteinuria made no difference between children and adults. (2) Global sclerosis and tubular atrophy/interstitial fibrosis occurred more commonly in adults than in children (24.29 % vs 8.20 %, 65.71 % vs 9.84 %, respectively) (P < 0.05). (3) The immunofluorescence deposition of complement C3 was more apparent in adults (P < 0.05). (4) The deposition of IgA, IgG, IgM, and C3 in kidneys was unrelated to the pathological types. (5) The deposition of IgG or IgM was related to the deposition of IgA or C3 in children and adults (P < 0.05).

CONCLUSIONS

Chronic kidney injury occurred more commonly in adult IgAVN patients compared to pediatric IgAVN patients. Immunoglobulin and complement deposits in kidneys were independent of the types of renal pathological injury. Additionally, IgG and IgM were probably involved in IgAVN pathogenesis.

摘要

背景

IgA 血管炎肾(IgAVN)是一种常见的继发性肾小球肾炎,可发生于任何年龄的患者。本研究旨在揭示儿童和成人 IgAVN 的肾脏组织病理学表现,并探讨 IgAVN 的潜在发病机制。

方法

共纳入 61 例儿童和 70 例成人 IgAVN 患者,均行肾脏活检。分析所有患者的一般资料、实验室参数及肾脏组织病理学表现。

结果

(1)儿童与成人患者在糖尿病、高血压及不同程度蛋白尿方面无差异。(2)成人患者中肾小球硬化和肾小管萎缩/间质纤维化的发生率明显高于儿童(24.29%比 8.20%,65.71%比 9.84%)(P<0.05)。(3)成人患者补体 C3 免疫荧光沉积更为明显(P<0.05)。(4)IgA、IgG、IgM 和 C3 在肾脏中的沉积与病理类型无关。(5)儿童和成人中 IgG 或 IgM 的沉积与 IgA 或 C3 的沉积有关(P<0.05)。

结论

与儿童 IgAVN 患者相比,成人 IgAVN 患者更易发生慢性肾脏损伤。肾脏中免疫球蛋白和补体的沉积与肾脏病理损伤类型无关。此外,IgG 和 IgM 可能参与 IgAVN 的发病机制。

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