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IgA glomerulonephritis

Audrey Uffing, Maria José Pérez-Sáez, Gaetano La Manna, Giorgia Comai, Clara Fischman, Samira Farouk, Roberto Ceratti Manfro, Andrea Carla Bauer, Bruno Lichtenfels, Juliana B Mansur, Hélio Tedesco-Silva, Gianna M Kirsztajn, Anna Manonelles, Oriol Bestard, Miguel Carlos Riella, Silvia Regina Hokazono, Carlos Arias-Cabrales, Elias David-Neto, Carlucci Gualberto Ventura, Enver Akalin, Omar Mohammed, Eliyahu V Khankin, Kassem Safa, Paolo Malvezzi, Michelle Marie O'Shaughnessy, Xingxing S Cheng, Paolo Cravedi, Leonardo V Riella
BACKGROUND: Long-term outcomes in kidney transplantation (KT) have not significantly improved during the past twenty years. Despite being a leading cause of graft failure, glomerular disease (GD) recurrence remains poorly understood, due to heterogeneity in disease pathogenesis and clinical presentation, reliance on histopathology to confirm disease recurrence, and the low incidence of individual GD subtypes. Large, international cohorts of patients with GD are urgently needed to better understand the disease pathophysiology, predictors of recurrence, and response to therapy...
September 12, 2018: BMC Nephrology
Mazdak A Khalighi, Laith Al-Rabadi, Meghana Chalasani, Mark Smith, Siddhartha Kakani, Monica P Revelo, Shane M Meehan
Introduction: Staphylococcal infection-related glomerulonephritis (GN) has been shown to represent a unique form of infection-related GN that contains IgA-dominant deposits and is often seen concurrently with the bacterial infection. Biopsies commonly reveal an endocapillary proliferative and/or exudative or mesangial proliferative GN. Rare cases have been reported to show cryoglobulin-like features, including hyaline pseudothrombi and wireloop deposits; however, detailed characterization of these cases is lacking...
September 2018: KI Reports
Daisuke Takada, Junichi Hoshino, Takayuki Fujii, Joichi Usui, Takeshi Fujii, Kenichi Ohashi, Kenmei Takaichi, Satoshi Suzuki, Kunihiro Yamagata, Yoshifumi Ubara
BACKGROUND: Tonsillectomy performed on patients with Immunoglobulin A glomerulonephritis (IgAN) improved the clinical remission rate as defined by urinary protein. But the number of times steroid pulse therapies (SP) should be administered remained poorly understood. METHOD: Multicenter, observational, retrospective cohort study at four hospitals in the Tokyo metropolitan area between March 1981 and December 2013. We divided patients into two groups: those treated with SP three times and those treated without SP or with SP only once or twice, and we analyzed standard Cox proportional hazard model unadjusted and adjusted the confounding covariates to estimate the hazard ratio for the primary outcome, the 30% estimated decline in glomerular filtration rate, in four models: model 1, unadjusted; model 2, adjusted for age, sex, body mass index, estimated glomerular filtration rate, biopsy year, proteinuria, hematuria, Japanese historical grade, systolic blood pressure, smoking history, and diabetes as a comorbidity; model 3, adjusted for propensity score, which was estimated by multiple logistic regressions; model 4, multilevel mixed-effects parametric survival models, whose facilities comprise the second level...
September 3, 2018: Clinical and Experimental Nephrology
Jonathan Barratt, Sydney C W Tang
Fifty years into the original description of IgA nephropathy, there is still no specific therapy for this condition and general measures including blood pressure control with blockers of the renin-angiotensin-aldosterone system and salt restriction remain the cornerstone to slow disease progression. Although the paucity in treatment advances could be related to the disease's complex pathogenesis, which requires multiple hits, heterogeneity as reflected by diverse ethnic differences, and genetic predisposition and histopathologic variations, many nonspecific and immunomodulatory agents have been tested with variable degrees of success and tribulations...
September 2018: Seminars in Nephrology
Hitoshi Suzuki, Yusuke Suzuki
IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis in the world. IgAN is characterized by mesangial deposits of IgA1-containing immune complexes. IgA1 usually co-deposits with complement C3 and variable IgG and/or IgM. Exactly 50 years have passed since IgAN was described, however, the pathogenesis of disease onset and progression have not been fully clarified. Animal models can re-create the complex immunologic microenvironments that foster human autoimmunity and nephritis and provide access to tissue compartments not readily examined in patients...
September 2018: Seminars in Nephrology
Stephen McAdoo, Frederick W K Tam
IgA nephropathy is the most common type of primary glomerulonephritis worldwide. At least 25% of patients may progress to kidney failure requiring dialysis or transplantation. Treatment of IgA nephropathy using generalized immunosuppression is controversial, with concerns regarding the balance of safety and efficacy in a nonspecific approach. This review describes the recent scientific evidence, and a current clinical trial, investigating whether spleen tyrosine kinase (SYK) may be a novel and selective therapeutic target for IgA nephropathy...
September 2018: Seminars in Nephrology
Joseph C K Leung, Kar Neng Lai, Sydney C W Tang
IgA nephropathy (IgAN), a common primary glomerulonephritis worldwide, is associated with a substantial risk of progression to end-stage renal failure. The disease runs a highly variable clinical course with frequent involvement of tubulointerstitial damage. A subgroup of IgAN with proximal tubular epithelial cells (PTECs) and tubulointerstitial damage often is associated with rapid progression to end-stage renal failure. Human mesangial cell-derived mediators lead to podocyte and tubulointerstitial injury via mesangial-podocytic-tubular cross-talk...
September 2018: Seminars in Nephrology
Maria F S Soares, Ian S D Roberts
IgA nephropathy (IgAN) is the most common glomerulonephritis worldwide. Since its description in 1968, a number of histologic descriptions and classification systems have emerged, the most recent of which is the Oxford Classification of IgAN. We present a historical panorama of histologic classifications of IgAN and discuss the most recent developments, updates, and future challenges of the Oxford Classification of IgAN.
September 2018: Seminars in Nephrology
Jan Novak, Jonathan Barratt, Bruce A Julian, Matthew B Renfrow
IgA nephropathy, the most common primary glomerulonephritis in the world and a frequent cause of end-stage renal disease, is characterized by typical mesangial deposits of IgA1, as described by Berger and Hinglaise in 1968. Since then, it has been discovered that aberrant IgA1 O-glycosylation is involved in disease pathogenesis. Progress in glycomic, genomic, clinical, analytical, and biochemical studies has shown autoimmune features of IgA nephropathy. The autoimmune character of the disease is explained by a multihit pathogenesis model, wherein overproduction of aberrantly glycosylated IgA1, galactose-deficient in some O-glycans, by IgA1-secreting cells leads to increased levels of circulatory galactose-deficient IgA1...
September 2018: Seminars in Nephrology
Francesco Paolo Schena, Ionut Nistor
IgA nephropathy (IgAN), or Berger's disease, is the most common primary glomerular disease worldwide, but varies largely in its geographic distribution. A systematic review of 1,619 publications from the five continental regions of the world was performed to assess the prevalence of IgAN in different worldwide regions and analyze factors responsible for geographic differences. All observational studies that described the prevalence and incidence data on glomerulonephritis were considered. IgAN is more frequent in Asian populations (45 cases per million population/y in Japan) than in Caucasians (31 cases per million population/y in France)...
September 2018: Seminars in Nephrology
Yuri de Deus Mont'alverne Parente, Amanda Lopes de Castro, Flávio Bezerra de Araújo, André Costa Teixeira, Ítalo Criszostomo Lima, Elizabeth De Francesco Daher
Rapidly progressive glomerulonephritis (RPGN) is a renal disease with an extensive differential diagnosis. This paper reports the case of a 55-year-old female patient diagnosed with Hansen's disease with acute progressive renal impairment after developing lower limb pyoderma. The association between Hansen's and kidney disease has been well documented, with glomerulonephritis (GN) ranked as the most common form of renal involvement. Post-infectious glomerulonephritis (PIGN) in adults has been associated with a number of pathogens occurring in diverse sites...
August 23, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
V Brkovic, M Milinkovic, M Kravljaca, M Lausevic, G Basta-Jovanovic, J Marković-Lipkovski, R Naumovic
Biopsy registries are one of the most important sources of accurate epidemiological data and the clinical presentation of renal diseases. A detailed analysis of clinicopathologic correlations over a period of 20 years (1987-2006) was performed earlier by our centre. The aim of this study was to check the current state and to register possible changes in clinicopathologic findings recorded under better socioeconomical circumstances and new management. Records of 665 renal biopsies performed at our institution were prospectively followed from 2007 to 2014...
August 10, 2018: Pathology, Research and Practice
Sanjeev Sethi, Fernando C Fervenza
A kidney biopsy is done to determine the etiology of the glomerulonephritis (GN) and the severity of the lesion, to identify whether other lesions, related to or not related to the GN, are present on the kidney biopsy and finally to ascertain the extent of chronicity of the GN. The etiology of GN is based on the classification of GN into five groups: immune complex-mediated GN, antineutrophil cytoplasmic antibody (ANCA)-associated GN, anti-glomerular basement membrane (GBM) GN, monoclonal immunoglobulin-mediated GN and C3 glomerulopathy...
August 13, 2018: Nephrology, Dialysis, Transplantation
Anri Sawada, Kunio Kawanishi, Shigeru Horita, Kazuya Omoto, Masayoshi Okumi, Tomokazu Shimizu, Sekiko Taneda, Shohei Fuchinoue, Hideki Ishida, Kazuho Honda, Motoshi Hattori, Kazunari Tanabe, Junki Koike, Yoji Nagashima, Kosaku Nitta
Background: Tubular basement membrane immune deposits (TBMID) has rarely been observed in renal allografts. It is usually found in BK virus nephropathy and immune complex glomerulonephritis; however, its significance is not well understood. We conducted a retrospective clinicopathological study on monoclonal immunoglobulin G (IgG) TBMID. Methods: We studied 7177 renal allograft biopsy specimens obtained from Tokyo Women's Medical University from 2007 to 2015 and performed light microscopic, electron microscopic and immunofluorescence studies...
August 16, 2018: Nephrology, Dialysis, Transplantation
Naohiro Toda, Masashi Mukoyama, Motoko Yanagita, Hideki Yokoi
Background: Glomerulonephritis, which causes inflammation in glomeruli, is a common cause of end-stage renal failure. Severe and prolonged inflammation can damage glomeruli and lead to kidney fibrosis. Connective tissue growth factor (CTGF) is a member of the CCN matricellular protein family, consisting of four domains, that regulates the signaling of other growth factors and promotes kidney fibrosis. Main body of the abstract: CTGF can simultaneously interact with several factors with its four domains...
2018: Inflammation and Regeneration
Giorgina Barbara Piccoli, Isabelle Annemijn Kooij, Rossella Attini, Benedetta Montersino, Federica Fassio, Martina Gerbino, Marilisa Biolcati, Gianfranca Cabiddu, Elisabetta Versino, Tullia Todros
BACKGROUND: IgA nephropathy is the most common primary glomerulonephritis in pregnancy and shares with other immunologic diseases and kidney diseases a relationship with adverse maternal outcomes, whose entity and pattern is only partially quantified. Recent studies provide new information and a systematic review regarded progression of kidney disease. The discussion of the outcomes with respect to low-risk pregnancies may help to perfect the estimation of the risks, and to identify specific research needs...
August 11, 2018: Journal of Clinical Medicine
Lorenza Di Genova, Stefania Ceppi, Maurizio Stefanelli, Susanna Esposito
Background : Imunoglobulin A (IgA) deficiency (IgAD) is the most common form of primary immunodeficiency in Western countries. There have been several reports on IgAD complicated by glomerulonephritis in adults, but only very few cases of IgAD with nephropathy have been reported in children. We present two cases of IgAD with relapsing nephrotic syndrome in pediatric age. Case presentation : A 4-year-old boy and a 2-year-old boy presented with bilateral periorbital oedema and weight gain. The results of laboratory tests revealed IgAD (IgA < 7 mg/dL), normal creatinine, hypoprotidaemia, hypoalbuminaemia, and nephrotic proteinuria...
August 9, 2018: International Journal of Environmental Research and Public Health
Meherzad Kutky, Sarah Aloudat
Rationale: Late-onset systemic lupus erythematosus (SLE) represents a specific subgroup of SLE, and although there is no strict age cut-off, 50 years is commonly used as the minimum age for disease onset. In this report, we present a case of a 74-year-old male with late-onset SLE and biopsy-proven lupus nephritis (LN). Presenting concerns of the patient: A 74-year-old male was referred to the nephrology clinic with a rapidly rising creatinine from a baseline of 60 µmol/L to 176 µmol/L...
2018: Canadian Journal of Kidney Health and Disease
Matthew P M Graham-Brown, Cristina Vasilica, Tom Oates, Ben Light, Christian Clausner, Apostolos Antonacoloulos, Lydia Y J Chen, Paula Ormandy, Jonathan Barratt
Background: IgA nephropathy is the most common cause of glomerulonephritis in the Western world and predominantly affects young adults. Demographically these patients are the biggest users of social media. With increasing numbers of patients turning to social media to seek information and support in dealing with their disease, analysis of social media streams is an attractive modern strategy for understanding and responding to unmet patient need. Methods: To identify unmet patient need in this population, a framework analysis will be undertaken of prospectively acquired social media posts from patients with IgA nephropathy, acquired from a range of different social media platforms...
August 2018: Clinical Kidney Journal
Nikhil Sanjay Deshpande, Rohit Tewari, Sonia Badwal, Satish Mendonca, Reena Bharadwaj
Background: Membranoproliferative glomerulonephritis (MPGN) has traditionally been classified on electron microscopy (EM) into different types based on the location of the immune complexes. Sethi et al. subsequently suggested a more relevant etiology-based and clinically useful classification based on immunofluorescence. Methods: In this retrospective study, 18 diagnosed cases of MPGN over a one-year period for which direct immunofluorescence (DIF) study results were available, were selected...
July 2018: Medical Journal, Armed Forces India
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