IgM-Associated Mesangial Proliferative Glomerulonephritis and Focal and Segmental Hyalinosis with Nephrotic Syndrome

Aubert, J; Humair, L; Chatelanat, F; A, de Torrenté

doi:10.1159/000166982

Cited by 12 publications

(10 citation statements)

References 19 publications

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“…There is still controversy about whether IgM nephropathy, MCD, and FSGS are individual entities or different aspects of the same disease [5, 6, 7, 8, 9]. However, pathologists usually separate the three conditions according to morphological criteria.…”

Section: Discussionmentioning

confidence: 99%

“…The existence of IgM nephropathy as a distinct clinical entity has long been a matter of controversy [5, 6, 7, 8, 9]. Indeed, some degree of mesangial hyperplasia with diffuse IgM deposition has been observed in both MCD and FSGS.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, some degree of mesangial hyperplasia with diffuse IgM deposition has been observed in both MCD and FSGS. Moreover, a progression from IgM nephropathy to FSGS has been documented on a repeat biopsy [6]. …”

Section: Discussionmentioning

confidence: 99%

“…Controversy still exists about whether minimal change disease (MCD), IgM nephropathy and FSGS are discrete disease entities or different aspects of the same disease [5, 6, 7, 8, 9]. In fact, mesangial IgM deposition is not a specific feature of IgM nephropathy, which may be associated with a spectrum of morphological appearances, varying from minimal glomerular lesions to focal sclerosis.…”

Section: Introductionmentioning

confidence: 99%

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Discordant Evolution of Asymptomatic Proteinuria in Identical Twins

Kim

Oh²,

Lee³

et al. 1999

Nephron

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We describe a pair of 17-year-old identical twin brothers with asymptomatic proteinuria, one of whom showed focal segmental glomerulosclerosis (FSGS) while the other showed immunoglobulin M (IgM) nephropathy. For each twin, audiological examination was normal. There was no family history of renal failure, deafness, or hematuria. HLA typing revealed an identical phenotype consisting of A25, A33, B44, B54, Cw1, Cw7, DR7 and DRB1. There is still controversy about whether minimal change disease, IgM nephropathy, and FSGS are discrete entities or different aspects of the same disease. The coexistence of IgM nephropathy and FSGS in identical twins suggests that the same genetic factors may be involved in the development of both diseases. However, although the brothers are identical twins, they had different eating habits and body weight. The twin who preferred to eat a protein-rich diet and who was heavier developed early proteinuria and manifested FSGS on renal biopsy. The discordant evolution of asymptomatic proteinuria in identical twins may provide a clue for the existence of environmental factors on the progression from IgM nephropathy to FSGS. Therefore, this report provides indirect support for the hypothesis that IgM nephropathy and FSGS represent different aspects in the spectrum of a single disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Discordant Evolution of Asymptomatic Proteinuria in Identical Twins

Kim

Oh²,

Lee³

et al. 1999

Nephron

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“…Many studies have examined the differential diagnosis of MCNS from FSGS. From a morphological perspective, IgM deposition and mesangial hypercellularity have been reported to be risk factors for transformation to FSGS [8][9][10]. Recent studies also sug- gest that the vacuolation of epithelial cells in nonsclerotic glomeruli areas is followed by the progression to FSGS [11,12].…”

Section: Introductionmentioning

confidence: 99%

Two Different Pathways of Glomerular Enlargement in Adults with Focal and Segmental Glomerulosclerosis: A Morphometric Study

Matsumae¹,

Fukuzaki²,

Takebayashi³

et al. 1998

Am J Nephrol

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The renal biopsy specimens obtained from 15 adults with focal and segmental glomerulosclerosis (FSGS) and 15 adults with minimal change nephrotic syndrome (MCNS) were morphometrically analyzed using light and electron microscopy. Moreover, initial biopsy specimens obtained from 10 adults who were diagnosed as MCNS and developed FSGS, based on repeat biopsy findings (‘MCNS’-FSGS), were also analyzed using electron microscopy. After comparing the actual values between the groups of FSGS and MCNS, the mean glomerular volume, the capillary volume per a glomerulus, the capillary filtration surface per a glomerulus, and the capillary diameter (Cap-D) were all larger in the FSGS group than in the MCNS group. In regard to the morphological values in the ‘MCNS’-FSGS group, both values of the surface density of the capillary filtering surface and the capillary diameter at the first biopsy specimens as well as those in the FSGS group were higher than those in the MCNS group. When analyzing the structural parameters, in the FSGS series, we found a high association of the percentage of obsolescent glomeruli (%SG) with the mean glomerular volume, the capillary volume per a glomerulus, the capillary filtering surface per a glomerulus and the capillary length per a glomerulus, however we failed to demonstrate the correlation between the %SG and the Cap-D. Thus, the glomerular structure in the ‘MCNS’-FSGS patients, even at the first renal biopsy, resembled that in FSGS, suggesting FSGS to be a distinct entity from MCNS. These data indicate that the enlargement of the capillary volume, resulting from the widening of the capillaries, was the initial structural event for adults with FSGS, while the elongation of the capillaries appeared to reflect some compensatory process for the decrease in the functioning nephron.

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Clinico-pathological characterization of mesangial proliferative glomerulonephritis with predominant deposition of IgM

Kishimoto

Arakawa

1999

Clinical and Experimental Nephrology

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Background. IgM nephropathy (IgMN) was first described in 1978 but whether IgMN is a distinct entity has not yet been confirmed. We tried to clarify the characteristics of IgMN on the basis of clinical and histological findings of patients who were treated and investigated by us. Methods. We evaluated 90 patients (group A) with mesangial proliferative glomerulonephritis (MesPGN) who exhibited more dominant mesangial deposits of IgM than of IgG and IgA. To clarify the significance of the IgM mesangial deposits, we divided these patients into two subgroups: group A1 comprised 30 patients with diffuse and global mesangial IgM deposits and group A2 comprised the other 60 patients, with focal segmental mesangial IgM deposits. Ninety Mes-PGN patients without predominant IgM deposits, excluding those with IgA nephropathy were studied as controls (group B). Results. Group A had significantly higher levels of serum IgM than group B (P Ͻ 0.01). The mean values for glomerular filtration rate (GFR), serum albumin, and CH50 in group A were significantly lower than those in group B (P Ͻ 0.01). Proteinuria in group A was significantly more severe than in group B (P Ͻ 0.05). Group A had a significantly higher incidence of adhesion (P Ͻ 0.01) and duplication (P Ͻ 0.05) of capillary loops than group B. They also demonstrated a significantly higher incidence of glomerular deposition of C1q and/or C4,C3, and fibrinogen than group B (P Ͻ 0.01). Conclusion. These findings suggest that the mesangial deposition of IgM is useful for assessing glomerular damage or renal dysfunction in MesPGN patients, regardless of the amount of mesangial IgM deposits. Furthermore, MesPGN with predominant IgM deposition, which includes both diffuse global and focal segmental deposition of IgM, should be referred to as IgM nephropathy.

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IgM-Associated Mesangial Proliferative Glomerulonephritis and Focal and Segmental Hyalinosis with Nephrotic Syndrome

Cited by 12 publications

References 19 publications

Discordant Evolution of Asymptomatic Proteinuria in Identical Twins

Discordant Evolution of Asymptomatic Proteinuria in Identical Twins

Two Different Pathways of Glomerular Enlargement in Adults with Focal and Segmental Glomerulosclerosis: A Morphometric Study

Clinico-pathological characterization of mesangial proliferative glomerulonephritis with predominant deposition of IgM

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