Primary Glomeruionephritis with Predominant Mesangial Immunoglobulin G Deposits -A Distinct Entity?

Abstract

Six cases of primary glomeruionephritis with predominant IgG deposits in the mesangium are described on the basis of a review of renal-biopsy-proven 1,116 cases with primary glomeruionephritis between 1977 and 1990. All patients were female (6-52 years old). Six patients appeared with microscopic hematuria: 3 with episodes of gross hematuria and 3 with mild proteinuria, but none with the nephrotic syndrome. Renal function was normal except for 1 case (52 years old) complicated with hypertension. Serum levels of immunoglobulins and complements were almost normal. Morphologically minor or focal/segmental glomerular alterations were observed. Immunofluorescence showed that pure mesangial IgG deposition was characterized in all cases, whereas no IgA nor IgM was found in any of them. Mesangial deposition of C3 and C1q was observed in 4 and 3 cases, respectively. Electron microscopy revealed dense deposits within the mesangial area in all cases. The clinical course was benign, and the complication with systemic diseases like a rheumatic disease was not observed. This primary glomeruionephritis is an entity characterized by low incidence in Japan, mild abnormalities in urinalysis, minor glomerular alterations with predominant mesangial IgG deposits and a relative benign course.

TJN-259 Improves Mesangial Lesions in Experimental Immunoglobulin A Nephropathy in ddY Mice

“…The mice were habituated for 1 week and then used for experiments. Induction of an accelerated model of IgA nephropathy was performed using the method reported by Sato et al 3,5) The right abdominal region was opened under ether anesthesia, and the right renal artery was ligated using suture thread to occlude the right kidney. After one week, colloidal carbon (Pilot Co., Tokyo, Japan) suspended in a 1% gelatin solution to block the reticuloendothelial system was administered intravenously to the mouse caudal vein at a dosage of 4 mg/100 g body weight.…”

“…On the other hand, unilateral nephrectomy, blockade of the reticuloendothelial system, and oral sensitization in ddY mice have demonstrated that the deposition of IgA and pathological changes in glomeruli may be induced earlier than those in spontaneous ddY mice. [3][4][5] Transforming growth factor-b1 (TGF-b1) induces matrix synthesis in renal tissues, leading to the progression of IgA nephropathy. 6,7) When added to cultured human mesangial cells, aggregated IgA1 from patients with IgA nephropathy induces increases in TGF-b1 gene expression and secretion of extracellular matrix in cultured mesangial cells.…”

Modern classification, progression factors, treatment and outcomes of primary mesangial proliferative glomerulonephritis

“…На основе обзора 1116 почечных биопсий при пер-вичном ГН, проведённых в период между 1977 и 1990 гг., появились публикации Sato и соавт. [14], позже -Yoshikawa и соавт. [15].…”

“…[14] 6 случаев IgG-нефрита, все больные были женского пола, с гематурией у всех и ПУ у 3 женщин, СКФ была в пределах нормы. Морфологически у всех была выявлена фокально-сегментарная альтерация, а при иммунофлюоресцентном методе у 4 -отло-жения фракции комплемента С3, у 1 -С1q.…”

Mesangial Proliferative Glomerulonephritis with Predominant Mesangial IgG Deposition in Renal Allograft

“…Although there are several reports on glomerulonephritis associated with mesangial IgM deposits (IgM nephropathy) [3,4], there are only three reports about glomerulonephritis associated with mesangial IgG deposits in Japan. Sato et al [5] have reported that 6 of 1,116 patients with primary glomerulonephritis had IgG nephropathy. All 6 cases had microscopic hematuria with slightproteinuria, and PAS-positive nodular deposits in the mesangium, similar to IgA nephropathy, were observed in 2 of these 6 cases.…”