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学科主题: 临床医学
题名:
Malignant hypertension in IgA nephropathy was not associated with background pathological phenotypes of glomerular lesions
作者: Jiang, Lei; Zhang, Jun-jun; Lv, Ji-cheng; Liu, Gang; Zou, Wan-zhong; Zhao, Ming-hui; Zhang, Hong
刊名: NEPHROLOGY DIALYSIS TRANSPLANTATION
发表日期: 2008-12-01
DOI: 10.1093/ndt/gfn371
卷: 23, 期:12, 页:3921-3927
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Transplantation ; Urology & Nephrology
研究领域[WOS]: Transplantation ; Urology & Nephrology
关键词[WOS]: ANTIENDOTHELIAL CELL ANTIBODIES ; SYSTEMIC-LUPUS-ERYTHEMATOSUS ; ENDOTHELIAL-CELLS ; VASCULITIS ; AUTOANTIBODIES ; PROGNOSIS
英文摘要:

Background. It was reported that IgA nephropathy (IgAN) was the major cause of secondary malignant hypertension (MHT). However, the pathogenesis of MHT secondary to IgAN (IgAN-MHT) is unknown and its association with glomerular pathological phenotypes remains inconclusive. The present study aimed to investigate whether glomerular pathological phenotypes and anti-endothelial cell antibodies (AECA) were associated with the occurrence of IgAN-MHT.

Methods. The glomerular pathological phenotypes of 45 patients with IgAN-MHT were analysed using Haas′ histologic grading system of IgAN. Sera were collected from 34 of the 45 patients with IgAN-MHT, 19 patients with primary MHT, 41 patients with non-MHT IgAN and 10 healthy volunteers. AECA of both IgG and IgA isotypes were detected by western blot analysis using human umbilical vein endothelial cell lysate as antigen.

Results. In the 45 patients with IgAN-MHT, 7 (15.56%), 5 (11.11%), 13 (28.89%), 9 (20%) and 11 (24.44%) patients were graded as Hass I, II, III, IV and V, respectively. Although the severity of non-ischaemic sclerosis, crescents and mesangial proliferation were significantly different between patients with different grades, the levels of blood pressure, SCr and proteinuria at presentation were comparable. Eleven and four protein bands of endothelial proteins could be blotted by AECA-IgG and AECA-IgA in sera from patients with IgAN-MHT. The prevalences of anti-121 kD AECA-IgG (15/34) and anti-92 kD AECA-IgA (10/34) in IgAN-MHT were significantly higher than that of primary MHT, non-MHT IgAN and normal controls, respectively. Patients with anti-92 kD AECA-IgA had more severe glomerular ischaemic sclerosis (6.25-92.86%, median 39.61%) than those without (0-91.67%, median 18.18%, P = 0.035). There was no significant difference in the prevalence of AECA between IgAN-MHT patients with different background glomerular lesions. Only one IgAN patient with MHT was found with both anti-121 kD AECA-IgG and anti-92 kD AECA-IgA. No particular manifestations were found.

Conclusions. The occurrence of IgAN-MHT was not associated with the background glomerular pathological phenotypes of IgAN. AECA might play a role in the pathogenesis of IgAN-MHT.

语种: 英语
所属项目编号: 30670981 ; 985-2-007-113
项目资助者: National Nature Science Foundation of China ; Foundation of Ministry of Education, People&prime ; s Republic of China
WOS记录号: WOS:000261170100030
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/59847
Appears in Collections:北京大学第一临床医学院_肾脏内科_期刊论文

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作者单位: Peking Univ, Div Renal, Hosp 1, Inst Nephrol,Key Lab Reanl Dis,Minist Hlth China, Beijing 100034, Peoples R China

Recommended Citation:
Jiang, Lei,Zhang, Jun-jun,Lv, Ji-cheng,et al. Malignant hypertension in IgA nephropathy was not associated with background pathological phenotypes of glomerular lesions[J]. NEPHROLOGY DIALYSIS TRANSPLANTATION,2008,23(12):3921-3927.
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