1. IgM mesangial deposition as a risk factor for relapses of adult-onset minimal change disease
- Author
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Chih Yu Yang, Der Cherng Tarng, Fan Yu Chen, An Hang Yang, Fu Pang Chang, Yang Ho, Bo Sheng Wu, and Cheng Wen Yang
- Subjects
Nephrology ,Adult ,Male ,medicine.medical_specialty ,030232 urology & nephrology ,Statistical difference ,lcsh:RC870-923 ,Gastroenterology ,Cohort Studies ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Recurrence ,Risk Factors ,Internal medicine ,medicine ,Humans ,Minimal change disease ,Risk factor ,Relapse ,Retrospective Studies ,Kidney ,biology ,business.industry ,Nephrosis, Lipoid ,Retrospective cohort study ,IgM mesangial deposition ,Middle Aged ,medicine.disease ,lcsh:Diseases of the genitourinary system. Urology ,Adult-onset ,Glomerular Mesangium ,medicine.anatomical_structure ,Immunoglobulin M ,030220 oncology & carcinogenesis ,biology.protein ,Female ,business ,Deposition (chemistry) ,Research Article - Abstract
BackgroundImmunoglobulin M (IgM) mesangial deposition in pediatric minimal change disease (MCD) has been reported to be associated with steroid dependence and poor renal outcomes. However, the evidence linking the impacts of IgM mesangial deposition to the treatment prognosis in adult-onset MCD is still elusive.MethodsIn this retrospective cohort study, 37 adult patients with MCD received kidney biopsies from January 2010 to May 2020. Immunofluorescence microscopy was performed and the patients dichotomized according to IgM mesangial deposition (12 patients with positive IgM deposition; 25 patients with negative IgM deposition). We analyzed the clinical features, the dosage of immunosuppressive agents, and the response to treatment for 2 years between the two groups.ResultsAnalysis of the clinical symptoms, the dosage of immunosuppressive treatment, and the time to remission revealed no statistical difference between the groups. However, compared to the negative IgM group, the frequency of relapses was significantly higher in the positive IgM group during the two-year follow-up period (the negative IgM group 0.25 episodes/year; the positive IgM group 0.75 episodes/year,p = 0.029). Furthermore, multivariate linear regression revealed that the positivity of IgM mesangial deposition is independently associated with the frequency of relapses (regression coefficient B 0.450, 95% CI 0.116–0.784,p = 0.010).ConclusionsOur findings indicated that adult-onset MCD patients with IgM mesangial deposition have a high risk of relapses. Therefore, intensive monitoring of disease activity should be considered in MCD adults with IgM mesangial deposition.
- Published
- 2021