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Glomerular Diseases Associated with Malignancies: Histopathological Pattern and Association with Circulating Autoantibodies

Aim: Glomerular diseases (GD) associated with malignancies (AM, GDAM) have unique features, which are important to recognize, in the light of the progress made in cancer therapy. We aimed to describe the clinical and histopathological characteristics of patients with GDAM in relation to the presence...

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Autores principales: Lionaki, Sophia, Marinaki, Smaragdi, Panagiotellis, Konstantinos, Tsoumbou, Ioanna, Liapis, George, Vlahadami, Ioanna, Tzioufas, Athanasios, Sfikakis, Petros, Boletis, Ioannis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7345950/
https://www.ncbi.nlm.nih.gov/pubmed/32466285
http://dx.doi.org/10.3390/antib9020018
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author Lionaki, Sophia
Marinaki, Smaragdi
Panagiotellis, Konstantinos
Tsoumbou, Ioanna
Liapis, George
Vlahadami, Ioanna
Tzioufas, Athanasios
Sfikakis, Petros
Boletis, Ioannis
author_facet Lionaki, Sophia
Marinaki, Smaragdi
Panagiotellis, Konstantinos
Tsoumbou, Ioanna
Liapis, George
Vlahadami, Ioanna
Tzioufas, Athanasios
Sfikakis, Petros
Boletis, Ioannis
author_sort Lionaki, Sophia
collection PubMed
description Aim: Glomerular diseases (GD) associated with malignancies (AM, GDAM) have unique features, which are important to recognize, in the light of the progress made in cancer therapy. We aimed to describe the clinical and histopathological characteristics of patients with GDAM in relation to the presence of circulating autoantibodies, pointing to potential immune pathogenic pathways connecting cancer to GD. Materials and Methods: The included patients were studied retrospectively on the basis of a kidney biopsy proving GD and a related biopsy to establish the diagnosis of AM. We recorded patients’ demographics, serological and laboratory parameters, histopathological findings, and the type of malignancy, GD, and therapy. Results: In total, 41 patients with GDAM, with a mean age of 63.1 (±10.7) years, were studied. In 28 (68.3%) cases, GD was associated with a solid tumor, and in 13 (31.7%) patients with a lymphoid malignancy. The most frequent histopathological pattern was membranous nephropathy (43.9%). Overall, at the time of GD diagnosis, 17% of the patients were positive for antinuclear antibodies (ANA), and 12.2% for antineutrophil cytoplasmic autoantibodies (ANCA), all against myeloperoxidase (MPO). In addition, 93.3% of the patients who had membranous nephropathy were negative for transmembrane glycoprotein M-type phospholipase A(2) receptor (PLA(2)R) antibody. Sixteen patients (39.0%) presented with acute nephritic syndrome, of whom five (31.25%) developed rapidly progressive glomerulonephritis. In a mean follow-up time of 36.1 (±28.3) months, nine (21.95%) patients ended up with end-stage kidney disease, and eight (19.5%) died. Conclusion: We found that 3.2% of patients who underwent a native kidney biopsy in our institution during the past decade, for any reason, were identified as having some type of GD associated with a malignancy. Serology indicated a significant presence of ANA or MPO-ANCA antibodies in patients with nephritic syndrome and the absence of PLA(2)R antibodies in patients with membranous nephropathy.
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spelling pubmed-73459502020-07-09 Glomerular Diseases Associated with Malignancies: Histopathological Pattern and Association with Circulating Autoantibodies Lionaki, Sophia Marinaki, Smaragdi Panagiotellis, Konstantinos Tsoumbou, Ioanna Liapis, George Vlahadami, Ioanna Tzioufas, Athanasios Sfikakis, Petros Boletis, Ioannis Antibodies (Basel) Article Aim: Glomerular diseases (GD) associated with malignancies (AM, GDAM) have unique features, which are important to recognize, in the light of the progress made in cancer therapy. We aimed to describe the clinical and histopathological characteristics of patients with GDAM in relation to the presence of circulating autoantibodies, pointing to potential immune pathogenic pathways connecting cancer to GD. Materials and Methods: The included patients were studied retrospectively on the basis of a kidney biopsy proving GD and a related biopsy to establish the diagnosis of AM. We recorded patients’ demographics, serological and laboratory parameters, histopathological findings, and the type of malignancy, GD, and therapy. Results: In total, 41 patients with GDAM, with a mean age of 63.1 (±10.7) years, were studied. In 28 (68.3%) cases, GD was associated with a solid tumor, and in 13 (31.7%) patients with a lymphoid malignancy. The most frequent histopathological pattern was membranous nephropathy (43.9%). Overall, at the time of GD diagnosis, 17% of the patients were positive for antinuclear antibodies (ANA), and 12.2% for antineutrophil cytoplasmic autoantibodies (ANCA), all against myeloperoxidase (MPO). In addition, 93.3% of the patients who had membranous nephropathy were negative for transmembrane glycoprotein M-type phospholipase A(2) receptor (PLA(2)R) antibody. Sixteen patients (39.0%) presented with acute nephritic syndrome, of whom five (31.25%) developed rapidly progressive glomerulonephritis. In a mean follow-up time of 36.1 (±28.3) months, nine (21.95%) patients ended up with end-stage kidney disease, and eight (19.5%) died. Conclusion: We found that 3.2% of patients who underwent a native kidney biopsy in our institution during the past decade, for any reason, were identified as having some type of GD associated with a malignancy. Serology indicated a significant presence of ANA or MPO-ANCA antibodies in patients with nephritic syndrome and the absence of PLA(2)R antibodies in patients with membranous nephropathy. MDPI 2020-05-25 /pmc/articles/PMC7345950/ /pubmed/32466285 http://dx.doi.org/10.3390/antib9020018 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lionaki, Sophia
Marinaki, Smaragdi
Panagiotellis, Konstantinos
Tsoumbou, Ioanna
Liapis, George
Vlahadami, Ioanna
Tzioufas, Athanasios
Sfikakis, Petros
Boletis, Ioannis
Glomerular Diseases Associated with Malignancies: Histopathological Pattern and Association with Circulating Autoantibodies
title Glomerular Diseases Associated with Malignancies: Histopathological Pattern and Association with Circulating Autoantibodies
title_full Glomerular Diseases Associated with Malignancies: Histopathological Pattern and Association with Circulating Autoantibodies
title_fullStr Glomerular Diseases Associated with Malignancies: Histopathological Pattern and Association with Circulating Autoantibodies
title_full_unstemmed Glomerular Diseases Associated with Malignancies: Histopathological Pattern and Association with Circulating Autoantibodies
title_short Glomerular Diseases Associated with Malignancies: Histopathological Pattern and Association with Circulating Autoantibodies
title_sort glomerular diseases associated with malignancies: histopathological pattern and association with circulating autoantibodies
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7345950/
https://www.ncbi.nlm.nih.gov/pubmed/32466285
http://dx.doi.org/10.3390/antib9020018
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