Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 5 de 5
Filter
1.
Clin J Am Soc Nephrol ; 3(6): 1637-43, 2008 Nov.
Article in English | MEDLINE | ID: mdl-18650410

ABSTRACT

BACKGROUND AND OBJECTIVES: The number of patients with C1q nephropathy (C1qN) in previous reports is small and the duration of follow-up is short. Our study describes the clinicopathologic correlation and clinical outcome through the mean follow-up period of 7.2 yr in 61 patients. DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS: Sixty-one patients, 1 to 67 yr of age, with C1qN were enrolled in this study. RESULTS: According to presentation at onset, patients were divided into two groups: asymptomatic urinary abnormalities (asymptomatic) (n = 36) and nephrotic syndrome (NS) (n = 25). Light microscopy showed minimal change disease (MCD) in 46 patients (75%), mesangial proliferative glomerulonephritis in 7 (12%), and focal segmental glomerulosclerosis (FSGS) in 8 (13%). The prevalence of MCD was higher in the NS group than in the asymptomatic group. Nine patients in the asymptomatic group and all patients in the NS group were treated with prednisolone and/or cyclosporine. Normal urinalysis was found in 10 patients in asymptomatic group and 8 in NS group during the follow-up. Thirteen patients in the NS group were frequent relapsers at the latest follow-up. Three patients with FSGS developed chronic renal failure 8 to 15 yr after the diagnosis. C1q deposits disappeared in 3 of 8 patients receiving repeat biopsy, and 2 of these 3 showed FSGS. CONCLUSIONS: The prognosis of C1qN is good, associated with MCD in a large number. In some patients, C1q deposits disappear through the follow-up period. FSGS may develop in some patients on repeat biopsies. Further investigation is critically needed to settle this issue.


Subject(s)
Complement C1q/metabolism , Glomerulonephritis, Membranoproliferative/immunology , Glomerulosclerosis, Focal Segmental/immunology , Nephrosis, Lipoid/immunology , Adolescent , Adult , Aged , Child , Child, Preschool , Cyclosporine/therapeutic use , Disease Progression , Female , Follow-Up Studies , Glomerulonephritis, Membranoproliferative/drug therapy , Glomerulonephritis, Membranoproliferative/pathology , Glomerulosclerosis, Focal Segmental/drug therapy , Glomerulosclerosis, Focal Segmental/pathology , Glucocorticoids/therapeutic use , Humans , Immunosuppressive Agents/therapeutic use , Infant , Kidney Failure, Chronic/immunology , Male , Middle Aged , Nephrosis, Lipoid/drug therapy , Nephrosis, Lipoid/pathology , Nephrotic Syndrome/immunology , Prednisolone/therapeutic use , Recurrence , Time Factors , Treatment Outcome , Young Adult
2.
Am J Kidney Dis ; 47(3): 412-8, 2006 Mar.
Article in English | MEDLINE | ID: mdl-16490619

ABSTRACT

BACKGROUND: Clinicopathologic correlation of C1q nephropathy is clarified poorly. The aim of our study is to clarify clinicopathologic correlation in childhood C1q nephropathy. METHODS: Thirty children aged 3 to 15 years who met criteria proposed by Jennette and Hipp were enrolled in this study. RESULTS: According to their presentation at onset, children were divided into 2 groups: the asymptomatic urinary abnormalities (asymptomatic) group (n = 18) and the nephrotic syndrome (NS) group (n = 12). Light microscopy showed minimal change disease (MCD) in 22 children (73%), mesangial proliferative glomerulonephritis in 6 children (20%), and focal segmental glomerulosclerosis (FSGS) in 2 children (7%). Four children in the asymptomatic group and all children in the NS group were administered prednisolone and/or cyclosporine. Normal urinalysis results were found in 8 children in the asymptomatic group and 3 children in the NS group during the follow-up period of 3 to 15 years. Eight children in the NS group were frequent relapsers at the latest follow-up. Two children with FSGS (1 child, asymptomatic group; 1 child, NS group) received dialysis 10 and 15 years after the diagnosis. There were no differences in histological findings and clinical outcomes between the 2 groups. Four children with MCD in the NS group underwent a second biopsy. C1q deposits disappeared in 2 children, and 1 of these 2 children showed FSGS. CONCLUSION: Childhood C1q nephropathy is found in a wide clinical spectrum. Some children showed disappearance of C1q deposits through the follow-up period. A large number of children with C1q nephropathy showed MCD. However, FSGS may develop in some children on repeated biopsy. Therefore, long-term follow-up is needed in children with C1q nephropathy.


Subject(s)
Complement C1q , Glomerulosclerosis, Focal Segmental/diagnosis , Glomerulosclerosis, Focal Segmental/immunology , Nephrosis, Lipoid/diagnosis , Nephrosis, Lipoid/immunology , Nephrotic Syndrome/diagnosis , Nephrotic Syndrome/immunology , Adolescent , Child , Child, Preschool , Female , Glomerulosclerosis, Focal Segmental/therapy , Humans , Male , Nephrosis, Lipoid/therapy , Nephrotic Syndrome/therapy
3.
Pathol Int ; 54(3): 174-80, 2004 Mar.
Article in English | MEDLINE | ID: mdl-14989740

ABSTRACT

The aim of the present study is to clarify the clinicopathological correlation of childhood IgA glomerulonephritis (GN) presenting diffuse endocapillary proliferation. Twenty-seven patients were used in the present study. The 27 patients were divided into three groups (mild, moderate and severe) according to the percentage of glomeruli displaying global endocapillary proliferation per total glomeruli at the first biopsy. The degree of both cellular crescent and lysis of the glomerular basement membrane (GBM) at the first biopsy was semiquantitatively evaluated. The degree of cellular crescent and lysis in the GBM was greater in the severe group than in the mild group. The degree of lysis of the GBM positively correlated with the degree of distribution of endocapillary proliferation. The degree of glomerular sclerosis at the second biopsy was greater in the severe group compared with the other two groups. The severity of cellular crescent at the first biopsy positively correlated with that of glomerular sclerosis at the second biopsy. Multiple logistic regression analysis indicated that the risk of glomerular sclerosis at the second biopsy was 19-fold higher in the odds ratio in the severe group compared with the mild group. In conclusion, the progression of glomerular sclerosis in serial biopsy is dependent on the degree of distribution of endocapillary proliferation and the severity of cellular crescents at the first biopsy in childhood IgA GN presenting diffuse endocapillary proliferation.


Subject(s)
Glomerulonephritis, IGA/pathology , Kidney Glomerulus/pathology , Adolescent , Basement Membrane/pathology , Basement Membrane/ultrastructure , Child , Child, Preschool , Diagnosis, Differential , Female , Humans , Kidney Glomerulus/blood supply , Kidney Glomerulus/ultrastructure , Male
4.
Pediatr Nephrol ; 17(5): 363-6, 2002 May.
Article in English | MEDLINE | ID: mdl-12042895

ABSTRACT

Familial non-immune-mediated glomerulopathy has recently been recognized as a distinct clinical entity. The presentation includes proteinuria, often in the nephrotic range, microscopic hematuria, and hypertension. Renal function may remain intact long term, or may progress slowly to renal failure. A 3-year-old boy was referred with proteinuria (>8 g/day), microscopic hematuria, and hypertension (184/150 mmHg). Renal function was intact. Diagnostic evaluation uncovered no evidence of systemic disease. A renal biopsy specimen showed no immune deposits in the glomeruli, but fibronectin deposits were detected in the peripheral loop and mesangium by immunofluorescence. The basement membrane was intact. Twelve other family members subsequently were found to have some renal pathology. Renal function was preserved during 7 years of follow-up. The pathogenesis of fibronectin glomerulopathy is discussed.


Subject(s)
Fibronectins/metabolism , Kidney Diseases/complications , Kidney Diseases/genetics , Kidney Glomerulus/metabolism , Nephrotic Syndrome/complications , Child, Preschool , Hematuria/complications , Hematuria/genetics , Humans , Hypertension/complications , Hypertension/genetics , Immunohistochemistry , Kidney Diseases/metabolism , Kidney Diseases/pathology , Male , Microscopy, Electron , Nephrotic Syndrome/pathology , Pedigree , Proteinuria/complications , Proteinuria/genetics
5.
Nihon Jinzo Gakkai Shi ; 44(1): 29-33, 2002 Jan.
Article in Japanese | MEDLINE | ID: mdl-11925944

ABSTRACT

During the period of 27 years from 1974 to 2000, acute episodes were studied retrospectively in 130 patients under 14 years of age with poststreptococcal acute glomerulonephritis(PSAGN). PSAGN cases have a variable clinical presentation from asymptomatic to severe oliguric acute renal failure(ARF). Proteinuria is nearly always present, but is less than 3.5 g/day. Nephrotic syndrome(NS) is not commonly observed in PSAGN. Among 130 patients, 5 cases had NS with ARF. The present study investigated a spectrum of NS with ARF and the significance of clinical features in PSAGN.


Subject(s)
Acute Kidney Injury/etiology , Glomerulonephritis/complications , Glomerulonephritis/microbiology , Nephrotic Syndrome/etiology , Streptococcal Infections , Streptococcus pyogenes , Acute Kidney Injury/pathology , Child , Female , Glomerulonephritis/pathology , Humans , Kidney/pathology , Male , Nephrotic Syndrome/pathology , Prognosis , Retrospective Studies , Severity of Illness Index
SELECTION OF CITATIONS
SEARCH DETAIL
...