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Concurrent IgA Nephropathy and Membranous Nephropathy, Is It an Overlap Syndrome?

IgA nephropathy (IgAN) and membranous nephropathy (MN) are common glomerulonephritis, the presence of which in the same patient– concurrent of IgAN and MN (cIgAN/MN) has been described occasionally. This study aims to show clinical-pathological features of cIgAN/MN and attempts to suggest underlying...

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Autores principales: He, Jia-Wei, Cui, Dong-Feng, Zhou, Xu-Jie, Chen, Pei, Li, Yang, Zhang, Xue, Wang, Yan-Na, Gan, Ting, Liu, Li-Jun, Shi, Su-Fang, Zhu, Li, Hou, Ping, Lv, Ji-Cheng, Zhang, Hong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8961684/
https://www.ncbi.nlm.nih.gov/pubmed/35359934
http://dx.doi.org/10.3389/fimmu.2022.846323
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author He, Jia-Wei
Cui, Dong-Feng
Zhou, Xu-Jie
Chen, Pei
Li, Yang
Zhang, Xue
Wang, Yan-Na
Gan, Ting
Liu, Li-Jun
Shi, Su-Fang
Zhu, Li
Hou, Ping
Lv, Ji-Cheng
Zhang, Hong
author_facet He, Jia-Wei
Cui, Dong-Feng
Zhou, Xu-Jie
Chen, Pei
Li, Yang
Zhang, Xue
Wang, Yan-Na
Gan, Ting
Liu, Li-Jun
Shi, Su-Fang
Zhu, Li
Hou, Ping
Lv, Ji-Cheng
Zhang, Hong
author_sort He, Jia-Wei
collection PubMed
description IgA nephropathy (IgAN) and membranous nephropathy (MN) are common glomerulonephritis, the presence of which in the same patient– concurrent of IgAN and MN (cIgAN/MN) has been described occasionally. This study aims to show clinical-pathological features of cIgAN/MN and attempts to suggest underlying pathogenesis using disease-specific biomarkers and a genomics approach. This retrospective cohort study described the clinical and pathological data from 137 patients with cIgAN/MN diagnosed in Peking University First Hospital from 2005 to 2019. One hundred primary IgAN and 100 MN cases were randomly selected as disease controls between the same time interval. Moreover, disease-specific biomarkers and polygenic risk score models were conducted to reveal the underlying pathogenesis. The median age of the cIgAN/MN cases was 45-year-old, and 46% were women. Compared to IgAN, patients with cIgAN/MN had a higher level of 24-hour proteinuria excretion but lower microscopic hematuria. They had a lower median level of galactose-deficient IgA1 (Gd-IgA1, 4.00 versus 5.45 μg/ml, P=0.002) as well as the standardized genetic risk scores of developing IgAN (GRSs: 0.05 versus 0.68, P<0.001). Compared to MN, patients with cIgAN/MN had a lower proportion of nephrotic syndrome and a lower level of albumin-to-creatinine ratio. However, the 24-hour proteinuria levels, serum lipid profiles, proportion of hypertension, and pathology classification were similar. Patients with cIgAN/MN had lower levels of plasma autoantibodies against the M-type transmembrane phospholipase A2 receptor (PLA2R) (11.23 versus 36.59 U/ml, P=0.005). Intriguingly, there were no statistical differences in standardized GRSs of developing MN between them (2.77 versus 3.02, P=0.326). Compared to IgAN, cIgAN/MN may lean towards MN more according to clinical-pathological features, disease-specific biomarker levels, and disease-specific genetic risk scores.
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spelling pubmed-89616842022-03-30 Concurrent IgA Nephropathy and Membranous Nephropathy, Is It an Overlap Syndrome? He, Jia-Wei Cui, Dong-Feng Zhou, Xu-Jie Chen, Pei Li, Yang Zhang, Xue Wang, Yan-Na Gan, Ting Liu, Li-Jun Shi, Su-Fang Zhu, Li Hou, Ping Lv, Ji-Cheng Zhang, Hong Front Immunol Immunology IgA nephropathy (IgAN) and membranous nephropathy (MN) are common glomerulonephritis, the presence of which in the same patient– concurrent of IgAN and MN (cIgAN/MN) has been described occasionally. This study aims to show clinical-pathological features of cIgAN/MN and attempts to suggest underlying pathogenesis using disease-specific biomarkers and a genomics approach. This retrospective cohort study described the clinical and pathological data from 137 patients with cIgAN/MN diagnosed in Peking University First Hospital from 2005 to 2019. One hundred primary IgAN and 100 MN cases were randomly selected as disease controls between the same time interval. Moreover, disease-specific biomarkers and polygenic risk score models were conducted to reveal the underlying pathogenesis. The median age of the cIgAN/MN cases was 45-year-old, and 46% were women. Compared to IgAN, patients with cIgAN/MN had a higher level of 24-hour proteinuria excretion but lower microscopic hematuria. They had a lower median level of galactose-deficient IgA1 (Gd-IgA1, 4.00 versus 5.45 μg/ml, P=0.002) as well as the standardized genetic risk scores of developing IgAN (GRSs: 0.05 versus 0.68, P<0.001). Compared to MN, patients with cIgAN/MN had a lower proportion of nephrotic syndrome and a lower level of albumin-to-creatinine ratio. However, the 24-hour proteinuria levels, serum lipid profiles, proportion of hypertension, and pathology classification were similar. Patients with cIgAN/MN had lower levels of plasma autoantibodies against the M-type transmembrane phospholipase A2 receptor (PLA2R) (11.23 versus 36.59 U/ml, P=0.005). Intriguingly, there were no statistical differences in standardized GRSs of developing MN between them (2.77 versus 3.02, P=0.326). Compared to IgAN, cIgAN/MN may lean towards MN more according to clinical-pathological features, disease-specific biomarker levels, and disease-specific genetic risk scores. Frontiers Media S.A. 2022-03-11 /pmc/articles/PMC8961684/ /pubmed/35359934 http://dx.doi.org/10.3389/fimmu.2022.846323 Text en Copyright © 2022 He, Cui, Zhou, Chen, Li, Zhang, Wang, Gan, Liu, Shi, Zhu, Hou, Lv and Zhang https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
He, Jia-Wei
Cui, Dong-Feng
Zhou, Xu-Jie
Chen, Pei
Li, Yang
Zhang, Xue
Wang, Yan-Na
Gan, Ting
Liu, Li-Jun
Shi, Su-Fang
Zhu, Li
Hou, Ping
Lv, Ji-Cheng
Zhang, Hong
Concurrent IgA Nephropathy and Membranous Nephropathy, Is It an Overlap Syndrome?
title Concurrent IgA Nephropathy and Membranous Nephropathy, Is It an Overlap Syndrome?
title_full Concurrent IgA Nephropathy and Membranous Nephropathy, Is It an Overlap Syndrome?
title_fullStr Concurrent IgA Nephropathy and Membranous Nephropathy, Is It an Overlap Syndrome?
title_full_unstemmed Concurrent IgA Nephropathy and Membranous Nephropathy, Is It an Overlap Syndrome?
title_short Concurrent IgA Nephropathy and Membranous Nephropathy, Is It an Overlap Syndrome?
title_sort concurrent iga nephropathy and membranous nephropathy, is it an overlap syndrome?
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8961684/
https://www.ncbi.nlm.nih.gov/pubmed/35359934
http://dx.doi.org/10.3389/fimmu.2022.846323
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