Immunofluorescent microscopy in patients with IgA nephropathy
https://doi.org/10.29235/1814-6023-2019-16-3-317-323
Abstract
The aim of the study was to evaluate relations between the deposition of IgA, IgG, IgM, C3, C1q and baseline clinical features and pathological findings.
According to exclusion criteria, 72 patients with diagnosed primary IgAN who were biopsied from 2015 to 2017 in the district of the Minsk city, Belarus were included for retrospective analysis. All biopsy had to be reviewed according to the Oxford classification (MEST-C). We examined the immunofluorescence staining with antibodies against IgG, IgA, IgM, C3, C1q.
Mean age was 32 (26; 42.5) years, 72.2% was men, 48.6% of the patients had arterial hypertension. Median of proteinuria was 870 (355; 1420) mg/day, 8.4% of the patients had isolated hematuria, serum creatinine – 104 (89; 126.5) µmol/l.
The patients with 3+ IgA deposits showed a significantly higher percentage of crescents (C1-2) than those with 2+ IgA deposits (p = 0.028). The presence of C3 deposits showed a gradual increase in the percentage of endothelial proliferation (E1) (p = 0.007). The degree of IgA deposits showed a significant negative relation to the IgM deposits (p = 0.01) and a positive relation to the C3 deposits (p = 0.001).
We found that the intensity of IgA and C3 deposits is associated with histopathology markers of the acute reaction (C1-2 and E1) according to the Oxford classification. At the same time, the appearance of the IgM deposits testifies the acute phase of the disease as well as the advanced sclerotic stage in some patients.
About the Authors
K. S. Komissarov
Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology
Belarus
Belarus
Kirill S. Komissarov – Ph. D. (Med.), Assistant Professor, Head of the Department
8, Semashko Str., 220116, Minsk
M. V. Dmitrieva
City Clinical Pathology Bureau, Minsk
Belarus
Belarus
Margarita V. Dmitrieva – pathologist
8/8, Semashko Str., 220116, Minsk
T. A. Letkovskaya
Belarusian State Medical University
Belarus
Belarus
Tatyiana A. Letkovskaya – Ph. D. (Med.), Assistant Professor, Head of the Department
83, Dzerzhinski Ave., 220116, Minsk
V. S. Pilotovich
Belarusian Medical Academy of Postgraduate Education
Belarus
Belarus
Valery S. Pilotovich – D. Sc. (Med.), Professor
3/3, P. Browka Str., 220013, Minsk
O. V. Krasko
United Institute of Informatics Problems of the National Academy of Sciences of Belarus
Belarus
Belarus
Olga V. Krasko – Ph. D. (Tech.), Assistant Professor, Leading researcher
6, Surganov Str., 220013, Minsk
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Review
For citations:
Komissarov K.S., Dmitrieva M.V., Letkovskaya T.A., Pilotovich V.S., Krasko O.V. Immunofluorescent microscopy in patients with IgA nephropathy. Proceedings of the National Academy of Sciences of Belarus, Medical series. 2019;16(3):317-323. (In Russ.) https://doi.org/10.29235/1814-6023-2019-16-3-317-323
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