Abstract
To identify a significance of mesangial IgA-IgG co-deposition in pediatric IgA nephropathy (IgAN) and Henoch-Schonlein purpura nephritis (HSPN), we performed multilateral investigation on clinical and pathological features, and short-term prognosis. From January 1998 to December 2008, 175 IgAN patients and 61 HSPN patients were diagnosed by renal biopsy in our hospital. Patients were divided into two groups according to the positive (71 cases in IgA nephropathy and 16 cases in HSPN) or negative deposition for mesangial IgG by immunofluorescence. Clinical, laboratory, and pathological data from each group at renal biopsy were analyzed using Student-t or χ2 test. Urinary protein excretion, number of urinary podocytes, and days of renal biopsy from onset were significantly increased, and 24-hour creatinine clearance (24-hr Ccr) was significantly decreased in IgG-postive IgAN group compared with IgG-negative IgAN groups. Pathologically, IgG-positive IgAN group showed increased mesangial proliferation, endocapillary proliferation, and crescent formation. Furthermore, IgG-positive IgAN group showed a higher tendency of sustained proteinuria than IgG-negative IgAN group after two years from the first renal biopsy. Only 24-hr Ccr was different in IgG-positive HSPN group compared with IgG-negative HSPN group. In conclusion, mesangial IgA-IgG co-deposition may have a role in the pathogenesis and progression of IgAN.
