Clinicopathological study on IgA nephritis

Clinicopathological study on IgA nephritis was carried out in order to clarify the factors to promote the progression of the disease. Total 118 cases of IgA nephritis confirmed with renal histology of the biopsied tissue were followed up in our kidney center at least two years following the biopsy....

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Published inNihon Jinzo Gakkai shi Vol. 31; no. 1; pp. 77 - 90
Main Author AKIMOTO, MICHIKO
Format Journal Article
LanguageJapanese
Published Japan Japanese Society of Nephrology 01.01.1989
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ISSN0385-2385
1884-0728
DOI10.14842/jpnjnephrol1959.31.77

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Abstract Clinicopathological study on IgA nephritis was carried out in order to clarify the factors to promote the progression of the disease. Total 118 cases of IgA nephritis confirmed with renal histology of the biopsied tissue were followed up in our kidney center at least two years following the biopsy. As a result, histological changes tended to be more severe in elder group at the time of biopsy and longer history of the disease. Renal function tended to be decreased in the cases with more proteinuria. Nephrotic syndrome seems to be one of the pocesses in which the disease is exacerbated. In addition, 21 cases with rather progressive courses following the biopsy revealed poor control of blood pressure, frequent upper respiratory infection, and more physical activities on their lives, which appear to be the risk factors. Clinical symptomes such as hematuria and proteinuria and histological changes were significantly more severe in the cases with IgA depositions spreading into the glomerular basement membrane, as compared to the ordinary cases with IgA depositions, limited in the mesangium. These results suggested that IgA depositions in glomerular basement membrane might be also one of the poor prognostic factors.
AbstractList Clinicopathological study on IgA nephritis was carried out in order to clarify the factors to promote the progression of the disease. Total 118 cases of IgA nephritis confirmed with renal histology of the biopsied tissue were followed up in our kidney center at least two years following the biopsy. As a result, histological changes tended to be more severe in elder group at the time of biopsy and longer history of the disease. Renal function tended to be decreased in the cases with more proteinuria. Nephrotic syndrome seems to be one of the processes in which the disease is exacerbated. In addition, 21 cases with rather progressive courses following the biopsy revealed poor control of blood pressure, frequent upper respiratory infection, and more physical activities on their lives, which appear to be the risk factors. Clinical symptoms such as hematuria and proteinuria and histological changes were significantly more severe in the cases with IgA depositions spreading into the glomerular basement membrane, as compared to the ordinary cases with IgA depositions, limited in the mesangium. These results suggested that IgA depositions in glomerular basement membrane might be also one of the poor prognostic factors.
Clinicopathological study on IgA nephritis was carried out in order to clarify the factors to promote the progression of the disease. Total 118 cases of IgA nephritis confirmed with renal histology of the biopsied tissue were followed up in our kidney center at least two years following the biopsy. As a result, histological changes tended to be more severe in elder group at the time of biopsy and longer history of the disease. Renal function tended to be decreased in the cases with more proteinuria. Nephrotic syndrome seems to be one of the processes in which the disease is exacerbated. In addition, 21 cases with rather progressive courses following the biopsy revealed poor control of blood pressure, frequent upper respiratory infection, and more physical activities on their lives, which appear to be the risk factors. Clinical symptoms such as hematuria and proteinuria and histological changes were significantly more severe in the cases with IgA depositions spreading into the glomerular basement membrane, as compared to the ordinary cases with IgA depositions, limited in the mesangium. These results suggested that IgA depositions in glomerular basement membrane might be also one of the poor prognostic factors.Clinicopathological study on IgA nephritis was carried out in order to clarify the factors to promote the progression of the disease. Total 118 cases of IgA nephritis confirmed with renal histology of the biopsied tissue were followed up in our kidney center at least two years following the biopsy. As a result, histological changes tended to be more severe in elder group at the time of biopsy and longer history of the disease. Renal function tended to be decreased in the cases with more proteinuria. Nephrotic syndrome seems to be one of the processes in which the disease is exacerbated. In addition, 21 cases with rather progressive courses following the biopsy revealed poor control of blood pressure, frequent upper respiratory infection, and more physical activities on their lives, which appear to be the risk factors. Clinical symptoms such as hematuria and proteinuria and histological changes were significantly more severe in the cases with IgA depositions spreading into the glomerular basement membrane, as compared to the ordinary cases with IgA depositions, limited in the mesangium. These results suggested that IgA depositions in glomerular basement membrane might be also one of the poor prognostic factors.
Clinicopathological study on IgA nephritis was carried out in order to clarify the factors to promote the progression of the disease. Total 118 cases of IgA nephritis confirmed with renal histology of the biopsied tissue were followed up in our kidney center at least two years following the biopsy. As a result, histological changes tended to be more severe in elder group at the time of biopsy and longer history of the disease. Renal function tended to be decreased in the cases with more proteinuria. Nephrotic syndrome seems to be one of the pocesses in which the disease is exacerbated. In addition, 21 cases with rather progressive courses following the biopsy revealed poor control of blood pressure, frequent upper respiratory infection, and more physical activities on their lives, which appear to be the risk factors. Clinical symptomes such as hematuria and proteinuria and histological changes were significantly more severe in the cases with IgA depositions spreading into the glomerular basement membrane, as compared to the ordinary cases with IgA depositions, limited in the mesangium. These results suggested that IgA depositions in glomerular basement membrane might be also one of the poor prognostic factors.
Author AKIMOTO, MICHIKO
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References 23) Lepetit JC, Cazes MH, Berthoux FC, Van Loghem E, Gagnen J, Segar J, Chapins Cellier C, Marselin M, Delange G, Garovov MR, Serre JL, Brizard CP, Carpenter CB: Genetic invesgigation in mesangial IgA nephropathy. Tissue Antigens 19: 108-114, 1982
6) Nicolls KM, Fairley FK, Dowling JP, Kincaid-Smith P: The clinical course of mesangial IgA associated nephropathy in adults. Quart J Med 210: 227-250, 1984
7) Chk a Y, Temura S, Takeuchi J: Renal survival rate of IgA nephropathy. Nephron 40: 189-194, 1985
22) 大沢源吾,米田昌道,平野宏,新開洋一,岡本満夫,進藤亨,橋本淳,松谷拓郎:IgA沈着を伴う微小変化型ネフローゼ症候群,厚生省特定疾患進行性腎障害調査研究班昭和58年度研究業績,464-469, 1984
30) Abuelo JG, Esparza AR, Matarese RA, Endreny RG, Carvalho JS, Allegra SR: Crescentic IgA nephropathy. Medicine 63: 396-496, 1984
25) Kasahara M, Hamada K, Okuyama T, Ishikawa N, Ogasawara K, Ikeda H, Takenouchi T, Wakisaka A, Aizawa M, Kataoka Y, Miyamoto R, Kohara M, Naito S, Kashiwagi N, Hiki Y: Role of HLA in IgA nephropathy. Clin Immunol Imrnunopatthol 25: 189-195, 1982
2) Nakamoto Y, Asano Y, Dohi K, Fujioka M, IIDA H, Kida H, Kibe Y, Hattori N, Takeuchi J: Primary IgA glomerulonephritis and Schönlein-Henoch purpura nephritis: Clinicopathological and immunohistological characteristics. Quart J Med 188: 495-516, 1978
9) Mustonen J, Pasternack A, Helm H, Nikkila M: Clinicopathologic correlations in a series of 143 patients with IgA glomerulonephritis. Am J Nem phrol 5: 150-157, 1985
10) Glassock RJ, Kurokawa K, Yoshida M, Sakai O, Okada M, Shigematsu H, Ohno J, Sakai H: IgAA nephropathy in Japan. Am J Nephrol 5: 127-137, 1985
18) Feiner HD, Cabili S, Baldwin DS, Schacht RG, Gallo GR: Intrarenal vasculer sclerosis in IgA nephropathy. Clin Nephrol 18: 183-192, 1982
11) 宮原正,酒井紀,北島武之,御手洗哲也,松本章,川村哲也,美田誠二:IgA腎症の経過に関する臨床病理学的検討,厚生省特定疾患進行性腎障害調査研究班昭和58年度研究業績,355-360, 1984
13) Meadow SR, Glosgow EF, White RHR, Moncrieff MW, Cameron JS, Ogg CS: Schönlein-Henoch nephritis. Quart J Med 41: 241-258, 1972
17) Coppo R, Basolo B, Piccoli G, Mazzucco G, Bulzomi MR, Roccatello D, DeMarehi M: IgAI and IgA2 immune complexes in primary IgA nephropathy and, Henoch-Schonlein nephritis. Clin Exp Immunol 57: 583-590, 1984
20) Lai KN, Ho CP, Chan KW, Yan KW, Mac-Moune Lai F, Vallance-Owen J.: Nephrotic range proteinuria-A good predictive index of disease in IgA nephropathy? Quart J Med 57: 677-688, 1985
3) Shirai T, Tomino Y, Sato M, Yoshiki T, Itoh T: IgA nephropathy: Chnicopathology and immnopathology, Contr Nephrol 9: 88-100, 1978
4) Kurt Lee SM, Ran VM, Franklin WA, Schiffer MS, Aronson AJ, Spargo BIT, Katz Al:IgA nephropathy: Morphologic predictors of progressive renal disease. Human Pathol 13: 314-322, 1982
16) 小出輝,白土公,榛沢進:IgA腎症の電子顕微鏡的検討,厚生省特定疾患進行性腎障害調査研究班昭和58年度研究業績,372-377, 1984
26) Doi T, Kanatsu K, Nagai H, Kohrogi N, Hamapshima Y: An overlapping syndrome of IgA nephropathy and membranous nephropathy? Nephron 35: 24-30, 1983
1) Bergcr J Hinglais: Les depots intercapillaires d'IgA-IgG. J Urol Nephrol 74: 694-695, 1968
5) Boyce NW, Holdworth SR, Thornson NM, Atkins RC: Clinicopathological associations in mesangial IgA nephropathy. Am J Nephrol 6: 246-252, 1986
19) Lawrence S, Pussell BA, Charlesworth JA: Mesangial IgA nephropathy: detection of defective reticulophagocytic function in vivo. Clin Nephrot 16: 280-283, 1983
28) 吉村光弘,木田寛,平原克己,片桐昌尋,竹田慎一,横山仁,越野慶隆,友杉直久,安部俊男,服部儒:IgA腎症における係蹄壁IgA沈着の意義 日腎誌 27: 1495-1502, 1985
24) Kashiwabara H, Shishido H, Tomura S, Tuchida. H, Miyajima T: Strong association between IgA nephropathy and HLA-DR4-antigen. Kidney Int 22: 377-382, 1982
15) 白土公:IgA腎症の電顕的検討 日腎誌 271: 1171-1183, 1985
12) 中本安,朝倉健一,三木一伸,保田正,今井裕一,高橋文夫,円山もも子,福田進,三浦亮:IgA腎炎に発現するネフローゼ症候群の再評価:自験例の検討および文献的考察 腎と透析 15: 55-61, 1985
21) 杉野信博,菊池典子,湯村和子,小俣正子,塚田津夏子,松村治,柚木雅至:IgA腎症に関する臨床病理学的考察,厚生省特定疾患進行性腎障害調査研究班昭和58年度研究業績,361-365, 1984
29) Sigematsu H, Kobayashi Y, Hiki Y, Kawao S: Ultrastructural glomerular loop abnormalities in IgA nephritis, Nephron 30: 1-7, 1982
14) Frascä GM, Vangelista A, Biagini G, Bonomini. V: Immunological tubulo interstitial deposits in IgA nephropathy. Kidney Iret 22: 184-191, 1982
8) D'amico G, Imbasciati E, Belgioioso GBD, Bertoli S, Fogazzi G, Minettl, Ponticelli C: Idiopathic IgA mesangial nephropathy: Clinical and histological study of 374 patients. Medicine 64: 49-60, 1985
27) 長沢俊彦,北本清:特異な組織像,または臨床像を呈したIgA腎症の3症例,厚生省特定疾患進行性腎障害調査研究班昭和58年度研究業績,470-475, 1984
References_xml – reference: 19) Lawrence S, Pussell BA, Charlesworth JA: Mesangial IgA nephropathy: detection of defective reticulophagocytic function in vivo. Clin Nephrot 16: 280-283, 1983
– reference: 4) Kurt Lee SM, Ran VM, Franklin WA, Schiffer MS, Aronson AJ, Spargo BIT, Katz Al:IgA nephropathy: Morphologic predictors of progressive renal disease. Human Pathol 13: 314-322, 1982
– reference: 13) Meadow SR, Glosgow EF, White RHR, Moncrieff MW, Cameron JS, Ogg CS: Schönlein-Henoch nephritis. Quart J Med 41: 241-258, 1972
– reference: 9) Mustonen J, Pasternack A, Helm H, Nikkila M: Clinicopathologic correlations in a series of 143 patients with IgA glomerulonephritis. Am J Nem phrol 5: 150-157, 1985
– reference: 18) Feiner HD, Cabili S, Baldwin DS, Schacht RG, Gallo GR: Intrarenal vasculer sclerosis in IgA nephropathy. Clin Nephrol 18: 183-192, 1982
– reference: 29) Sigematsu H, Kobayashi Y, Hiki Y, Kawao S: Ultrastructural glomerular loop abnormalities in IgA nephritis, Nephron 30: 1-7, 1982
– reference: 10) Glassock RJ, Kurokawa K, Yoshida M, Sakai O, Okada M, Shigematsu H, Ohno J, Sakai H: IgAA nephropathy in Japan. Am J Nephrol 5: 127-137, 1985
– reference: 3) Shirai T, Tomino Y, Sato M, Yoshiki T, Itoh T: IgA nephropathy: Chnicopathology and immnopathology, Contr Nephrol 9: 88-100, 1978
– reference: 6) Nicolls KM, Fairley FK, Dowling JP, Kincaid-Smith P: The clinical course of mesangial IgA associated nephropathy in adults. Quart J Med 210: 227-250, 1984
– reference: 17) Coppo R, Basolo B, Piccoli G, Mazzucco G, Bulzomi MR, Roccatello D, DeMarehi M: IgAI and IgA2 immune complexes in primary IgA nephropathy and, Henoch-Schonlein nephritis. Clin Exp Immunol 57: 583-590, 1984
– reference: 20) Lai KN, Ho CP, Chan KW, Yan KW, Mac-Moune Lai F, Vallance-Owen J.: Nephrotic range proteinuria-A good predictive index of disease in IgA nephropathy? Quart J Med 57: 677-688, 1985
– reference: 22) 大沢源吾,米田昌道,平野宏,新開洋一,岡本満夫,進藤亨,橋本淳,松谷拓郎:IgA沈着を伴う微小変化型ネフローゼ症候群,厚生省特定疾患進行性腎障害調査研究班昭和58年度研究業績,464-469, 1984
– reference: 16) 小出輝,白土公,榛沢進:IgA腎症の電子顕微鏡的検討,厚生省特定疾患進行性腎障害調査研究班昭和58年度研究業績,372-377, 1984
– reference: 28) 吉村光弘,木田寛,平原克己,片桐昌尋,竹田慎一,横山仁,越野慶隆,友杉直久,安部俊男,服部儒:IgA腎症における係蹄壁IgA沈着の意義 日腎誌 27: 1495-1502, 1985
– reference: 14) Frascä GM, Vangelista A, Biagini G, Bonomini. V: Immunological tubulo interstitial deposits in IgA nephropathy. Kidney Iret 22: 184-191, 1982
– reference: 24) Kashiwabara H, Shishido H, Tomura S, Tuchida. H, Miyajima T: Strong association between IgA nephropathy and HLA-DR4-antigen. Kidney Int 22: 377-382, 1982
– reference: 2) Nakamoto Y, Asano Y, Dohi K, Fujioka M, IIDA H, Kida H, Kibe Y, Hattori N, Takeuchi J: Primary IgA glomerulonephritis and Schönlein-Henoch purpura nephritis: Clinicopathological and immunohistological characteristics. Quart J Med 188: 495-516, 1978
– reference: 11) 宮原正,酒井紀,北島武之,御手洗哲也,松本章,川村哲也,美田誠二:IgA腎症の経過に関する臨床病理学的検討,厚生省特定疾患進行性腎障害調査研究班昭和58年度研究業績,355-360, 1984
– reference: 1) Bergcr J Hinglais: Les depots intercapillaires d'IgA-IgG. J Urol Nephrol 74: 694-695, 1968
– reference: 30) Abuelo JG, Esparza AR, Matarese RA, Endreny RG, Carvalho JS, Allegra SR: Crescentic IgA nephropathy. Medicine 63: 396-496, 1984
– reference: 21) 杉野信博,菊池典子,湯村和子,小俣正子,塚田津夏子,松村治,柚木雅至:IgA腎症に関する臨床病理学的考察,厚生省特定疾患進行性腎障害調査研究班昭和58年度研究業績,361-365, 1984
– reference: 15) 白土公:IgA腎症の電顕的検討 日腎誌 271: 1171-1183, 1985
– reference: 8) D'amico G, Imbasciati E, Belgioioso GBD, Bertoli S, Fogazzi G, Minettl, Ponticelli C: Idiopathic IgA mesangial nephropathy: Clinical and histological study of 374 patients. Medicine 64: 49-60, 1985
– reference: 5) Boyce NW, Holdworth SR, Thornson NM, Atkins RC: Clinicopathological associations in mesangial IgA nephropathy. Am J Nephrol 6: 246-252, 1986
– reference: 7) Chk a Y, Temura S, Takeuchi J: Renal survival rate of IgA nephropathy. Nephron 40: 189-194, 1985
– reference: 12) 中本安,朝倉健一,三木一伸,保田正,今井裕一,高橋文夫,円山もも子,福田進,三浦亮:IgA腎炎に発現するネフローゼ症候群の再評価:自験例の検討および文献的考察 腎と透析 15: 55-61, 1985
– reference: 27) 長沢俊彦,北本清:特異な組織像,または臨床像を呈したIgA腎症の3症例,厚生省特定疾患進行性腎障害調査研究班昭和58年度研究業績,470-475, 1984
– reference: 26) Doi T, Kanatsu K, Nagai H, Kohrogi N, Hamapshima Y: An overlapping syndrome of IgA nephropathy and membranous nephropathy? Nephron 35: 24-30, 1983
– reference: 23) Lepetit JC, Cazes MH, Berthoux FC, Van Loghem E, Gagnen J, Segar J, Chapins Cellier C, Marselin M, Delange G, Garovov MR, Serre JL, Brizard CP, Carpenter CB: Genetic invesgigation in mesangial IgA nephropathy. Tissue Antigens 19: 108-114, 1982
– reference: 25) Kasahara M, Hamada K, Okuyama T, Ishikawa N, Ogasawara K, Ikeda H, Takenouchi T, Wakisaka A, Aizawa M, Kataoka Y, Miyamoto R, Kohara M, Naito S, Kashiwagi N, Hiki Y: Role of HLA in IgA nephropathy. Clin Immunol Imrnunopatthol 25: 189-195, 1982
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Snippet Clinicopathological study on IgA nephritis was carried out in order to clarify the factors to promote the progression of the disease. Total 118 cases of IgA...
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SubjectTerms Adolescent
Adult
Age Factors
Female
Glomerulonephritis, IGA - pathology
Glomerulonephritis, IGA - physiopathology
Hematuria
Humans
IgA nephritis
Immunoglobulin A - metabolism
Kidney - pathology
Kidney - physiopathology
Kidney - ultrastructure
Male
Microscopy
Middle Aged
poor prognostic factors
Proteinuria
Time Factors
Title Clinicopathological study on IgA nephritis
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