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Transplant Proc. 2014 Jan-Feb;46(1):124-9. doi: 10.1016/j.transproceed.2013.07.072.

Latent mesangial immunoglobulin A deposition in long-term functioning kidney does not correlate with disease progression and may exhibit fluctuating patterns.

Author information

  • 1Division of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: shara@med.kobe-u.ac.jp.
  • 2Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, Osaka, Japan.
  • 3Sakurabashi Circulate Organ Clinic, Osaka, Japan.
  • 4Yamaguchi's Pathology Laboratory, Matsudo, Chiba, Japan.
  • 5Inoue Hospital, Osaka, Japan.
  • 6Division of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan.

Abstract

BACKGROUND:

Latent mesangial immunoglobulin (Ig)A deposition in long-term functioning kidney does not correlate with disease progression and may exhibit fluctuating patterns Mesangial IgA deposition without urinary abnormalities (latent mesangial IgA deposition) is occasionally observed in non-episode biopsies of kidney allografts. However, the histologic features of latent IgA deposition have not been fully characterized.

METHODS:

To better identify the clinicopathologic background of subclinical mesangial IgA deposition, we compared the clinical and histologic characteristics of long-term functioning kidney allografts with and without latent IgA deposition.

RESULTS:

Among 29 patients with a posttransplant duration of >10 years, 37.9% exhibited latent mesangial IgA deposition. Biopsies indicated that renal function at the time of and 5 years before subclinical mesangial IgA deposition was generally similar. HLA-DR4 and HLA-Bw51 showed a nonsignificant trend to be more frequent in the IgA-positive group. Histologic investigation demonstrated no changes in disease scores based on the Banff 2009 classification between groups. Immunofluorescence revealed co-deposition of C3 at >1+ intensity in 72% IgA-positive patients. Immunohistochemical analysis revealed that IgA deposition per se did not cause notable increases in intraglomerular α-smooth muscle actin (SMA)-positive cells. One patient with subclinical IgA deposition demonstrated a waxing and waning pattern in the amount of IgA deposition.

CONCLUSION:

This study suggests that subclinical IgA deposition in long-term functioning kidney allografts is not associated with progressive course in clinical and pathologic findings. Furthermore, the amount of subclinical IgA deposition may exhibit fluctuating patterns in some cases.

Copyright © 2014 Elsevier Inc. All rights reserved.

[PubMed - indexed for MEDLINE]
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