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The size of palatine tonsils cannot be used to decide the indication of tonsillectomy for IgA nephropathy

Background. Tonsillectomy is one of the treatment strategies for immunoglobulin A nephropathy (IgAN). The relationship between the indication of tonsillectomy and the size of palatine tonsils (PTs) in patients with IgAN remains controversial. Methods. This retrospective cohort study investigated 57...

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Autores principales: Sato, Mitsuhiro, Adachi, Mika, Kosukegawa, Hideyuki, Nomura, Yuri, Watanabe, Kenichi, Sato, Toshinobu, Taguma, Yoshio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5381239/
https://www.ncbi.nlm.nih.gov/pubmed/28396738
http://dx.doi.org/10.1093/ckj/sfw125
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author Sato, Mitsuhiro
Adachi, Mika
Kosukegawa, Hideyuki
Nomura, Yuri
Watanabe, Kenichi
Sato, Toshinobu
Taguma, Yoshio
author_facet Sato, Mitsuhiro
Adachi, Mika
Kosukegawa, Hideyuki
Nomura, Yuri
Watanabe, Kenichi
Sato, Toshinobu
Taguma, Yoshio
author_sort Sato, Mitsuhiro
collection PubMed
description Background. Tonsillectomy is one of the treatment strategies for immunoglobulin A nephropathy (IgAN). The relationship between the indication of tonsillectomy and the size of palatine tonsils (PTs) in patients with IgAN remains controversial. Methods. This retrospective cohort study investigated 57 patients with IgAN who underwent tonsillectomy combined with steroid pulse therapy (SPT). They were classified into two groups, the hypertrophy group and the nonhypertrophy group, according to the weight of their excised PTs. The effects of tonsillectomy combined with SPT on clinical remission (CR) and the histopathological findings of PTs were compared between the two groups. Results. During the mean follow-up period of 45.5 (range 6–133) months, 78.9% of the patients achieved CR (79.3 versus 78.6%, P = 0.945) and the baseline serum creatinine doubled only in one patient in the nonhypertrophy group (0 versus 3.6%, P = 0.491). No significant difference was observed in the incidence of CR between the two groups by the Kaplan–Meier method (P = 0.839). The predictor for CR, identified in Cox proportional hazards models, was baseline proteinuria [hazard ratio 0.14 (95% CI 0.032–0.621) P = 0.010]. Although macroscopic pus plugs were observed on the surface of PTs in almost 60% of patients in each group, microscopic pus plugs in the crypt and the enlarged interfollicular area were observed in all patients. Conclusions. The treatment effect of tonsillectomy combined with SPT and the pathological features of PTs in IgAN were equal, regardless of the size of the PTs. Therefore, the size of PTs should not be included as a factor when deciding the indication of tonsillectomy for IgAN.
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spelling pubmed-53812392017-04-10 The size of palatine tonsils cannot be used to decide the indication of tonsillectomy for IgA nephropathy Sato, Mitsuhiro Adachi, Mika Kosukegawa, Hideyuki Nomura, Yuri Watanabe, Kenichi Sato, Toshinobu Taguma, Yoshio Clin Kidney J Glomerulopathies Background. Tonsillectomy is one of the treatment strategies for immunoglobulin A nephropathy (IgAN). The relationship between the indication of tonsillectomy and the size of palatine tonsils (PTs) in patients with IgAN remains controversial. Methods. This retrospective cohort study investigated 57 patients with IgAN who underwent tonsillectomy combined with steroid pulse therapy (SPT). They were classified into two groups, the hypertrophy group and the nonhypertrophy group, according to the weight of their excised PTs. The effects of tonsillectomy combined with SPT on clinical remission (CR) and the histopathological findings of PTs were compared between the two groups. Results. During the mean follow-up period of 45.5 (range 6–133) months, 78.9% of the patients achieved CR (79.3 versus 78.6%, P = 0.945) and the baseline serum creatinine doubled only in one patient in the nonhypertrophy group (0 versus 3.6%, P = 0.491). No significant difference was observed in the incidence of CR between the two groups by the Kaplan–Meier method (P = 0.839). The predictor for CR, identified in Cox proportional hazards models, was baseline proteinuria [hazard ratio 0.14 (95% CI 0.032–0.621) P = 0.010]. Although macroscopic pus plugs were observed on the surface of PTs in almost 60% of patients in each group, microscopic pus plugs in the crypt and the enlarged interfollicular area were observed in all patients. Conclusions. The treatment effect of tonsillectomy combined with SPT and the pathological features of PTs in IgAN were equal, regardless of the size of the PTs. Therefore, the size of PTs should not be included as a factor when deciding the indication of tonsillectomy for IgAN. Oxford University Press 2017-04 2017-01-21 /pmc/articles/PMC5381239/ /pubmed/28396738 http://dx.doi.org/10.1093/ckj/sfw125 Text en © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Glomerulopathies
Sato, Mitsuhiro
Adachi, Mika
Kosukegawa, Hideyuki
Nomura, Yuri
Watanabe, Kenichi
Sato, Toshinobu
Taguma, Yoshio
The size of palatine tonsils cannot be used to decide the indication of tonsillectomy for IgA nephropathy
title The size of palatine tonsils cannot be used to decide the indication of tonsillectomy for IgA nephropathy
title_full The size of palatine tonsils cannot be used to decide the indication of tonsillectomy for IgA nephropathy
title_fullStr The size of palatine tonsils cannot be used to decide the indication of tonsillectomy for IgA nephropathy
title_full_unstemmed The size of palatine tonsils cannot be used to decide the indication of tonsillectomy for IgA nephropathy
title_short The size of palatine tonsils cannot be used to decide the indication of tonsillectomy for IgA nephropathy
title_sort size of palatine tonsils cannot be used to decide the indication of tonsillectomy for iga nephropathy
topic Glomerulopathies
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5381239/
https://www.ncbi.nlm.nih.gov/pubmed/28396738
http://dx.doi.org/10.1093/ckj/sfw125
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