Journal of Pathology and Translational Medicine

Original Articles

Clinicopathologic Features of IgA-Dominant Postinfectious Glomerulonephritis: Tai Yeon Koo, Gheun-Ho Kim, Moon Hyang Park; Korean J Pathol. 2012;46(2):105-114. Published online April 25, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.2.105

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Background

IgA-dominant acute postinfectious glomerulonephritis (APIGN) is a recently recognized morphologic variant of APIGN, but its clinicopathologic features were not clearly characterized. We will present demographic, clinical and renal biopsy findings from seven patients with IgA-dominant APIGN with a literature review.

Methods

All renal biopsy specimens (n=1,119) processed by the Department of Pathology in Hanyang University Hospital from 2005 to 2009 were reviewed. Seven patients with IgA-dominant APIGN were identified, and their clinical data analyzed.

Results

All patients had renal failure, hematuria and proteinuria. One was diabetic, and none of the patients had previous renal diseases. Three had clinical infections at the time of presentation: 2 with methicillin-resistant Staphylococcus aureus and one with rickettsial infection. Light microscopically diffuse endocapillary proliferative and exudative glomerulonephritis was found in all cases. Immunofluorescence microscopy showed granular IgA deposits along peripheral capillary walls and in mesangium. Ultrastructurally, subepithelial 'humps' with mesangial deposits were noted. End-stage renal disease developed in two patients, chronic renal failure was stationary in two, and azotemia improved in three.

Conclusions

Various infections including rickettsiosis preceded IgA-dominant APIGN in both diabetics and nondiabetics. Because the prognosis of IgA-dominant APIGN is poor, early diagnosis based on renal biopsy is required.

Citations

Citations to this article as recorded by

Staphylococcus aureus Infection-Related Glomerulonephritis with Dominant IgA Deposition
Mamiko Takayasu, Kouichi Hirayama, Homare Shimohata, Masaki Kobayashi, Akio Koyama
International Journal of Molecular Sciences.2022; 23(13): 7482. CrossRef
A rare case of Immunoglobulin A dominant post-infectious glomerulonephritis (IgA PIGN) in a young patient
A. Saghar, G. Klaus, B. Trutnau, M. Kömhoff, H. J. Gröne, S. Weber
BMC Nephrology.2022;[Epub] CrossRef
IgA-Dominant Infection-Associated Glomerulonephritis Following SARS-CoV-2 Infection
Aurora Pérez, Isidro Torregrosa, Luis D’Marco, Isabel Juan, Liria Terradez, Miguel Ángel Solís, Francesc Moncho, Carmen Carda-Batalla, María J. Forner, Jose Luis Gorriz
Viruses.2021; 13(4): 587. CrossRef
Relationship between blood neutrophil‐lymphocyte ratio and renal tubular atrophy/interstitial fibrosis in IgA nephropathy patients
Lingxiong Chai, Kedan Cai, Kaiyue Wang, Qun Luo
Journal of Clinical Laboratory Analysis.2021;[Epub] CrossRef
The Continuing Need for Electron Microscopy in Examination of Medical Renal Biopsies: Examples in Practice
Michifumi Yamashita, Mercury Y. Lin, Jean Hou, Kevin Y.M. Ren, Mark Haas
Glomerular Diseases.2021; 1(3): 145. CrossRef
Clinicopathologic features of infection-related glomerulonephritis with IgA deposits: a French Nationwide study
Elodie Miquelestorena-Standley, Charlotte Jaulerry, Marie-Christine Machet, Nolwenn Rabot, Christelle Barbet, Aurélie Hummel, Alexandre Karras, Cyril Garrouste, Thomas Crepin, Didier Ducloux, Maud Cousin, Catherine Albert, Joseph Rivalan, Emilie Cornec-Le
Diagnostic Pathology.2020;[Epub] CrossRef
IgA nephropathy and infections
Cristiana Rollino, Gisella Vischini, Rosanna Coppo
Journal of Nephrology.2016; 29(4): 463. CrossRef
<i>Staphylococcus</i>-associated Glomerulonephritis
Dong Yeol Shin, Sung Han Kim, Ji Wan Lee, Ki Ju Chang, Seung Ha Hwang, Yong Mee Cho, Soon Bae Kim
The Korean Journal of Medicine.2016; 90(2): 148. CrossRef
Use of steroid therapy in immunoglobulin A-dominant poststaphylococcal glomerulonephritis
Mahesh Eswarappa, Vijay Varma, K.C. Gurudev
Hong Kong Journal of Nephrology.2015; 17(2): 46. CrossRef
Clinicopathologic Features of IgA-Dominant Infection-Associated Glomerulonephritis: A Pooled Analysis of 78 Cases
Ru Bu, Qian Li, Zhi-yu Duan, Jie Wu, Pu Chen, Xiang-mei Chen, Guang-yan Cai
American Journal of Nephrology.2015; 41(2): 98. CrossRef
Garland-pattern postinfectious glomerulonephritis with IgA-dominant deposition
Makoto Kanno, Kenichi Tanaka, Hiroshi Kimura, Kimio Watanabe, Yoshimitsu Hayashi, Koichi Asahi, Masaaki Nakayama, Kensuke Joh, Tsuyoshi Watanabe
CEN Case Reports.2014; 3(1): 56. CrossRef

An Analysis of Focal Segmental Glomerulosclerosis according to Morphologic Subtypes.: Min Ju Kim, Dokyung Kim, Beom Jin Lim, Hyeon Joo Jeong; Korean J Pathol. 2010;44(6):589-596.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.6.589

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Abstract PDF

BACKGROUND
The histological subtypes of focal segmental glomerulosclerosis (FSGS) have different significance and influence clinical presentations and outcomes in patients with FSGS. However, no such data has been reported in Korea.
METHODS
We reviewed renal biopsy specimens of 69 adult patients who were diagnosed with idiopathic FSGS between 2000 and 2008, subclassified them according to the Columbia classification and correlated the results with clinical findings.
RESULTS
The frequencies of the FSGS subtypes were not otherwise specified (NOS) (n = 28), tip (n = 21), perihilar (n = 11), collapsing (n = 5) and cellular types (n = 4) in descending order. Nephrotic syndrome was more common in patients with the tip and collapsing types than the perihilar type. The prevalence of chronic kidney disease stage 4/5 at the time of renal biopsy was significantly higher in patients with the cellular type than the NOS or the tip type. The remission rate after treatment tended to be higher in patients with the NOS type (22.0%) and the tip type (15.2%) than the perihilar (6.8%) and collapsing types (3.4%).
CONCLUSIONS
Classifying FSGS subtypes may be helpful to predict of clinical features and renal outcomes.

Citations

Citations to this article as recorded by

Podocytopathy and Morphologic Changes in Focal Segmental Glomerulosclerosis
Hyeon Joo Jeong
Journal of the Korean Society of Pediatric Nephrology.2013; 17(1): 13. CrossRef
Pathology and Classification of Focal Segmental Glomerulosclerosis
Yong-Jin Kim
Journal of the Korean Society of Pediatric Nephrology.2012; 16(1): 21. CrossRef

Fine Needle Aspiration Cytology of Mucoepidermoid Carcinoma of the Salivary Gland.: Jeong Seok Moon, Hwa Eun Oh, Joo Han Lee, Aee Ree Kim, Chul Hwan Kim, Han Kyeom Kim, Mee Ja Park, Nam Hee Won; Korean J Cytopathol. 1997;8(2):135-142.

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Abstract PDF: PURPOSE: There is no specific treatment guidelines for Henoch-Schonlein (HS) nephritis. Therefore we performed this study to observe the effect of long term steroid therapy combined with azathioprine METHODS: Treatment protocols; 1) Steroid pulse therapy: methylprednisolon 30 mg/kg/dose, maximum 1 gm, intravenously 6 times for alternate day. 2) Oral steroid was given 2 mg/kg/day for 1 month, 1 mg/kg/day for following I month and alternate day oral steroid combined with azathioprine 2 mg/kg/day for 2 years. RESULTS: Time period from HSP to onset of HS nephritis was between 2 weeks to 5 months with mean 7.4+/-7.4 weeks. Clinical remission were seen in 4 cases out of 5 (80%). Mean time period with disappearance of proteinuria and microscopic hematuria were 5+/-2.4 month and 13.3+/-2.9 month respectively. On pathologic findings by ISKDC, 3 cases were grade IIIb, 2 cases were grade IV in first kidney biopsies and showed pathologic improvement in follow up kidney biopsies after 2 years treatment. CONCLUSION: As there no definitive treatment for HS nephritis so far, our study of long term oral steroid therapy with azathioprine was effective in clinical and histologic aspect. Therefore further study in HS nephritis with in a large group will be needed in the future.

Clinico-pathological Study on Hepatitis B virus-Associated Nephropathy.: Moon Hyang Park, Hae Sun Ahn; Korean J Pathol. 1992;26(3):215-228.

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Abstract PDF: To clarify the characteristics of HBV-associated renal lesions, renal biopsies obtained from 22 HBsAg seropositive patients(M:F=32:1) were studied. Other than two(age 4 and 12), all were adults(17-77 y.o.). Twelve of the patients had nephrotic syndrome(NS), 5 NS and hematuria(H), 10 proteinuria and H, one gross H, one microscopic H, and 4 normal urinalysis at the time of biopsy. Light microscopy showed minimal change lesion(MCL) in 9 cases, mesangial proliferative glomerulonephritis(MSPGN) in 6, MPGN type I in 7, MPGN type III in 6, and mebranous nephropathy(MGN) in 5 cases. There were variable immunofluorescent(IF) findings of 25 cases studied; IF staining were predominant with IgG in 10 cases, with IgA in 5 and with IgM in 2 cases. Complements tended to be more strong for C1 &/or C4 than C3. In electron microscopic(EM) studies of MCL group, rare mesangial deposits were noted(3/5). In MSPGN, aside from mesangial deposits, there were occasional subendothelia(2/4) or subepithelial(1/4) deposits. In MPGN type I, in addition to the usual EM features of MPGN, some subepithelial deposits were also observed in 5 cases. In MGN, 3 out of 4 showed subendothelial deposits. Among 7 cases stained for HBsAg all were negative with IF and 2 were positive with PAP method. It is concluded that clinico-pathological findings of HBV-associated nephropathy are variable and partly show lupus-like features, different from primary glomerulopathy.

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