Endocapillary proliferative glomerulonephritis with hepatitis B virus antigen deposition in children:a clinicopathologic analysis of 9 cases / 临床与实验病理学杂志

ABSTRACT

Purpose To analyze clinicopathologic and prognostic features in 9 cases of children endocapillary proliferative glomerulone-phritis with hepatitis B virus antigen deposition ( HBV-ECPGN) . Methods Retrospective analysis of demographic information, clini-cal manifestations, laboratory parameters, pathological and prognostic features was carried out for 9 cases of HBV-ECPGN and 13 cases of acute poststreptococcal infection endocapillary proliferative glomerulonephritis ( APS-ECPGN) for comparison. Renal biopsy tissue were fixed in formalin and embedded in paraffin, stained with HE, PAS and PAM-Masson. Immunohistochemical study with EliVision method was performed. Three cases were submitted for electron microscopy. Results There were 7 males and 2 females ( M ∶ F=7 ∶ 2) of HBV-ECPGN. The median age was 10. 3 years. Serum C4 deposition ratio HBV-ECPGN was significantly greater than APS-ECPGN group (P<0. 05). There was an average of 11. 2 weeks of HBV-ECPGN kidney disease duration, which was significantly lon-ger than an average of 3. 8 weeks of APS-ECPGN group (P<0. 05). There was no disease relapse in all cases during 53. 55 months follow-up. C4d deposit was significantly stronger in all HBV-ECPGN cases compared with control group (APS-ECPGN cases). There were no significant differences in deposit of IgG, IgM, IgA, C3d and C1q between the two groups. HBsAg deposit in juxtaglomerular sites was identified in all cases. Conclusions Serum C4 decrease is more common in HBV-ECPGN than APS-ECPGN. Which may be associated with HBV infection, there is longer disease duration of HBV-ECPGN. C4d deposit is significantly stronger than control group, suggesting pathogenesis of HBV-ECPGN and APS-ECPGN is different. HBsAg deposit may be closely related to the pathogene-sis of HBV-ECPGN. HBsAg deposit in juxtaglomerular sites may be characteristic of HBV-ECPGN.