Welch T R, McAdams J
Division of Nephrology, Children's Hospital Research Foundation, Cincinnati, OH, USA.
Am J Kidney Dis. 1998 Oct;32(4):589-92. doi: 10.1016/s0272-6386(98)70021-6.
Colabeling with complement compont C1q or immunoglobulin M (IgM) is occasionally reported in biopsy specimens from patients with IgA nephropathy. The significance of this finding has been questioned. In 83 children and young adults with otherwise typical IgA nephropathy, 15 patients had more than trace mesangial labeling for IgM or C1q. Of these, 14 patients (93%) had greater than 1 + proteinuria at the time of biopsy. This was in marked distinction to the patients with no mesangial labeling for these reactants, only 15% of whom had greater than 1 + proteinuria. The children with IgM or C1q colabel did not differ from those lacking this finding in age at presentation, length of follow-up, or current renal function. In childhood IgA nephropathy, colabeling with IgM or C1q is seen frequently, probably is a function of heavy proteinuria at the time of biopsy, and does not contribute adversely to outcome.
在IgA肾病患者的活检标本中,偶尔会有补体成分C1q或免疫球蛋白M(IgM)共标记的报道。这一发现的意义受到了质疑。在83例具有典型IgA肾病的儿童和年轻人中,15例患者的系膜IgM或C1q标记超过微量。其中,14例患者(93%)在活检时蛋白尿大于1+。这与那些系膜无这些反应物标记的患者形成显著差异,后者只有15%的患者蛋白尿大于1+。有IgM或C1q共标记的儿童在发病年龄、随访时间或目前的肾功能方面与无此发现的儿童并无差异。在儿童IgA肾病中,IgM或C1q共标记很常见,可能是活检时大量蛋白尿的一种表现,对预后并无不良影响。