GLOMERULAR INJURY IN END-STAGE LIVER-DISEASE - ROLE OF CIRCULATING IGG AND IGM IMMUNE-COMPLEXES

被引：13

作者：

MILNER, LS

HOUSER, MT

KOLBECK, PC

ANTONSON, DL

MCDONALD, TL

MARKIN, RS

SHAW, BW

机构：

[1] Department of Pediatrics, University of Nebraska Medical Center, Omaha, 68198-2165, Nebraska

[2] Department of Pathology, University of Nebraska Medical Center, Omaha, Nebraska

[3] Department of Microbiology, University of Nebraska Medical Center, Omaha, Nebraska

[4] Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska

来源：

PEDIATRIC NEPHROLOGY | 1993年 / 7卷 / 01期

关键词：

END-STAGE LIVER DISEASE; CIRCULATING IMMUNE COMPLEXES; IMMUNOGLOBULINS; MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS;

D O I：

10.1007/BF00861550

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

The relationship of IgG- and IgM-bound circulating immune complexes and immune dysfunction to glomerular injury was evaluated in 15 children with end-stage liver disease (ESLD) awaiting liver transplantation. Compared with age-matched controls, children with ESLD had significantly (P <0.01) increased serum IgG, IgA, and IgM levels, as well as IgG- and IgM-bound circulating immune complexes. Furthermore, they showed a significant (P <0.05) depression of C3 and C4 levels compared with controls. Hematuria occurred in 66% of children with ESLD, and the urinary protein/creatinine ratio was also significantly (P <0.01) increased compared with controls (4.65 +/- 2.56 vs. 0.16 +/- 0.04 mg/mg). Light microscopy of renal biopsy tissue obtained from 6 children with ESLD at the time of transplantation demonstrated mesangial proliferation and expansion with basement membrane splitting. This was associated with subendothelial deposits on electron-microscopic examination, compatible with a diagnosis of membranoproliferative glomerulonephritis. By immunofluorescence, deposition of IgG, IgA, and IgM occurred in various combinations with co-deposition of complement fragments. We conclude that membrano-proliferative glomerulonephritis is a common finding in children with ESLD, probably due to entrapment of circulating IgG- and IgM-bound immune complexes.

引用

页码：6 / 10

页数：5

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