Clinical and immunological characteristics of patients with combined anti-glomerular basement membrane disease and IgA nephropathy.
IgA nephropathy
anti-glomerular basement membrane disease
antigen
antigen-specific IgA
epitope
Journal
Clinical kidney journal
ISSN: 2048-8505
Titre abrégé: Clin Kidney J
Pays: England
ID NLM: 101579321
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
18
10
2022
medline:
4
9
2023
pubmed:
4
9
2023
entrez:
4
9
2023
Statut:
epublish
Résumé
The combination of anti-glomerular basement membrane (GBM) disease and immunoglobulin A nephropathy (IgAN) has been well documented in sporadic cases, but lacks overall assessment in large collections. Herein, we investigated the clinical and immunological characteristics and outcome of this entity. Seventy-five consecutive patients with biopsy-proven anti-GBM disease from March 2012 to March 2020 were screened. Among them, patients with concurrent IgAN were identified and enrolled. The control group included biopsied classical anti-GBM patients during the same period, excluding patients with IgAN, other glomerular diseases or tumors, or patients with unavailable blood samples and missing data. Serum IgG and IgA autoantibodies against GBM were detected by enzyme-linked immunosorbent assay, as were circulating IgG subclasses against GBM. Fifteen patients with combined anti-GBM disease and IgAN were identified, accounting for 20% (15/75) of all patients. Among them, nine were male and six were female, with an average (± standard deviation) age of 46.7 ± 17.3 years. Thirty patients with classical anti-GBM disease were enrolled as controls, with 10 males and 20 females at an average age of 45.4 ± 15.3 years. Patients with combined anti-GBM disease and IgAN had restricted kidney involvement without pulmonary hemorrhage. Compared with classical patients, anti-GBM patients with IgAN presented with significantly lower levels of serum creatinine on diagnosis (6.2 ± 2.9 vs 9.5 ± 5.4 mg/dL, Concurrent IgAN was not rare in anti-GBM disease. Patients showed milder kidney lesions and better recovery after immunosuppressive therapies. This might be partly explained by lower prevalence of anti-GBM IgG1 and IgG3 in these patients.
Sections du résumé
Background
UNASSIGNED
The combination of anti-glomerular basement membrane (GBM) disease and immunoglobulin A nephropathy (IgAN) has been well documented in sporadic cases, but lacks overall assessment in large collections. Herein, we investigated the clinical and immunological characteristics and outcome of this entity.
Methods
UNASSIGNED
Seventy-five consecutive patients with biopsy-proven anti-GBM disease from March 2012 to March 2020 were screened. Among them, patients with concurrent IgAN were identified and enrolled. The control group included biopsied classical anti-GBM patients during the same period, excluding patients with IgAN, other glomerular diseases or tumors, or patients with unavailable blood samples and missing data. Serum IgG and IgA autoantibodies against GBM were detected by enzyme-linked immunosorbent assay, as were circulating IgG subclasses against GBM.
Results
UNASSIGNED
Fifteen patients with combined anti-GBM disease and IgAN were identified, accounting for 20% (15/75) of all patients. Among them, nine were male and six were female, with an average (± standard deviation) age of 46.7 ± 17.3 years. Thirty patients with classical anti-GBM disease were enrolled as controls, with 10 males and 20 females at an average age of 45.4 ± 15.3 years. Patients with combined anti-GBM disease and IgAN had restricted kidney involvement without pulmonary hemorrhage. Compared with classical patients, anti-GBM patients with IgAN presented with significantly lower levels of serum creatinine on diagnosis (6.2 ± 2.9 vs 9.5 ± 5.4 mg/dL,
Conclusions
UNASSIGNED
Concurrent IgAN was not rare in anti-GBM disease. Patients showed milder kidney lesions and better recovery after immunosuppressive therapies. This might be partly explained by lower prevalence of anti-GBM IgG1 and IgG3 in these patients.
Identifiants
pubmed: 37664576
doi: 10.1093/ckj/sfad068
pii: sfad068
pmc: PMC10469093
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1480-1488Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.
Déclaration de conflit d'intérêts
Nothing to disclose.
Références
Kidney Int. 2016 Apr;89(4):897-908
pubmed: 26994577
Saudi J Kidney Dis Transpl. 2017 Nov-Dec;28(6):1404-1407
pubmed: 29265054
Kidney Int. 2003 Dec;64(6):2108-20
pubmed: 14633133
J Biol Chem. 1988 Sep 15;263(26):13374-80
pubmed: 3417661
Am J Nephrol. 2022;53(5):397-406
pubmed: 35462364
Nephron. 2002 May;91(1):43-50
pubmed: 12021518
Front Immunol. 2020 Sep 03;11:2035
pubmed: 33013861
Clin Kidney J. 2012 Dec;5(6):545-8
pubmed: 26069798
Kidney Int. 2014 Apr;85(4):945-52
pubmed: 24048374
Exp Ther Med. 2016 May;11(5):1889-1892
pubmed: 27168822
J Exp Med. 1967 Dec 1;126(6):989-1004
pubmed: 4964566
Clin Nephrol. 2014 Feb;81(2):138-41
pubmed: 23149250
Indian J Nephrol. 2019 Sep-Oct;29(5):375-377
pubmed: 31571751
Hum Immunol. 2009 Jun;70(6):425-9
pubmed: 19364515
Pathology. 2019 Apr;51(3):336-338
pubmed: 30837085
Pathology. 1984 Jul;16(3):324-30
pubmed: 6393013
Clin Nephrol. 1998 Feb;49(2):124-8
pubmed: 9524784
Ren Fail. 2006;28(1):7-14
pubmed: 16526313
Am J Kidney Dis. 1989 Apr;13(4):355-6
pubmed: 2705454
CEN Case Rep. 2013 May;2(1):6-10
pubmed: 28509211
Am J Kidney Dis. 2002 May;39(5):E21
pubmed: 11979333
N Engl J Med. 2010 Jul 22;363(4):343-54
pubmed: 20660402
Kidney Int. 2004 Oct;66(4):1535-40
pubmed: 15458448
Ultrastruct Pathol. 1988 Jan-Feb;12(1):17-26
pubmed: 3354074
J Pathol. 1988 Jan;154(1):7-18
pubmed: 3346772
Kidney Int. 2017 Sep;92(3):693-702
pubmed: 28506760
J Pathol Transl Med. 2019 Nov;53(6):399-402
pubmed: 31525832
Nat Rev Nephrol. 2011 Jul 19;7(12):697-705
pubmed: 21769105
J Biol Chem. 1999 Apr 16;274(16):11267-74
pubmed: 10196215
Clin Exp Immunol. 1987 Aug;69(2):341-9
pubmed: 3652535
J Biol Chem. 2000 Feb 25;275(8):6030-7
pubmed: 10681598
Mol Med Rep. 2012 May;5(5):1212-4
pubmed: 22366925
N Engl J Med. 2002 Sep 5;347(10):738-48
pubmed: 12213946
N Engl J Med. 2013 Jun 20;368(25):2402-14
pubmed: 23782179
Am J Kidney Dis. 1999 Sep;34(3):565-8
pubmed: 10469870
BMC Nephrol. 2019 Jan 25;20(1):25
pubmed: 30683055
Kidney Int. 1990 Mar;37(3):965-70
pubmed: 2179617
Am J Case Rep. 2015 Dec 01;16:849-53
pubmed: 26621456
Ann Intern Med. 1979 Jul;91(1):21-5
pubmed: 111592