Limits...
Clinical features of IgA nephropathy with serum ANCA positivity: a retrospective case-control study.

Yang YZ, Shi SF, Chen YQ, Chen M, Yang YH, Xie XF, Zou R, Lv JC, Liu LJ, Zhang H - Clin Kidney J (2015)

Bottom Line: Histologically, there was a significantly higher percentage of fibrinoid necrosis in glomeruli in ANCA-positive IgAN patients and in AASV patients compared with ANCA-negative IgAN patients (35, 25 and 0%, respectively, P = 0.003).After immunosuppressive therapy, ANCA-positive crescentic IgAN patients were more likely to withdraw from dialysis (75 versus 9.1%, P = 0.03) and not to reach end-stage renal disease within 6 months (11.1 versus 66.7%, P = 0.01) compared with ANCA-negative crescentic IgAN patients.However, renal prognosis was relatively better in ANCA-positive crescentic IgAN patients after aggressive immunosuppressive therapy in the short term, compared with ANCA-negative patients.

View Article: PubMed Central - PubMed

Affiliation: Renal Division, Key Laboratory of Renal Disease, Ministry of Health of China , Peking University First Hospital, Institute of Nephrology, Peking University , Beijing , PR China.

ABSTRACT

Background: The coexistence of IgA nephropathy (IgAN) and antineutrophil cytoplasmic autoantibodies (ANCAs) is relatively rare. Only a few studies have reported the features of these patients.

Methods: We studied the clinical and histological features of 20 ANCA-positive IgAN patients. They were compared with ANCA-negative IgAN patients (n = 40) and ANCA-associated systemic vasculitis (AASV) patients (n = 40) with a randomly selected and matched proportion of crescentic glomeruli. Furthermore, 9 ANCA-positive crescentic IgAN patients out of the 20 cases were compared with two control groups with crescentic nephritis.

Results: ANCA-positive IgAN patients showed older age, lower haemoglobin and higher inflammatory indicator levels at baseline, and a higher percentage of general symptoms and pulmonary involvement, compared with ANCA-negative IgAN patients, and were comparable to AASV patients. Histologically, there was a significantly higher percentage of fibrinoid necrosis in glomeruli in ANCA-positive IgAN patients and in AASV patients compared with ANCA-negative IgAN patients (35, 25 and 0%, respectively, P = 0.003). After immunosuppressive therapy, ANCA-positive crescentic IgAN patients were more likely to withdraw from dialysis (75 versus 9.1%, P = 0.03) and not to reach end-stage renal disease within 6 months (11.1 versus 66.7%, P = 0.01) compared with ANCA-negative crescentic IgAN patients.

Conclusions: IgAN patients with ANCA positivity showed more severe clinical and histological features when compared with ANCA-negative IgAN patients and were comparable to AASV patients. However, renal prognosis was relatively better in ANCA-positive crescentic IgAN patients after aggressive immunosuppressive therapy in the short term, compared with ANCA-negative patients.

No MeSH data available.


Related in: MedlinePlus

ESRD in ANCA-positive crescentic IgAN, ANCA-negative crescentic IgAN and ANCA-associated crescentic glomerulonephritis patients (simple random sampling). ANCA, antineutrophil cytoplasmic autoantibody; IgAN, IgA nephropathy; ESRD, end-stage renal disease; GN, glomerulonephritis.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4581394&req=5

SFV078F2: ESRD in ANCA-positive crescentic IgAN, ANCA-negative crescentic IgAN and ANCA-associated crescentic glomerulonephritis patients (simple random sampling). ANCA, antineutrophil cytoplasmic autoantibody; IgAN, IgA nephropathy; ESRD, end-stage renal disease; GN, glomerulonephritis.

Mentions: Nine out of 20 ANCA-positive IgAN patients were diagnosed with crescentic IgAN. Tables 3 and 4 and Figure 2 show the comparison of clinical and histological data, response to therapy and prognosis among ANCA-positive crescentic IgAN, ANCA-negative crescentic IgAN and ANCA‚Äďassociated crescentic glomerulonephritis patients (simple random sampling).Table 3.


Clinical features of IgA nephropathy with serum ANCA positivity: a retrospective case-control study.

Yang YZ, Shi SF, Chen YQ, Chen M, Yang YH, Xie XF, Zou R, Lv JC, Liu LJ, Zhang H - Clin Kidney J (2015)

ESRD in ANCA-positive crescentic IgAN, ANCA-negative crescentic IgAN and ANCA-associated crescentic glomerulonephritis patients (simple random sampling). ANCA, antineutrophil cytoplasmic autoantibody; IgAN, IgA nephropathy; ESRD, end-stage renal disease; GN, glomerulonephritis.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4581394&req=5

SFV078F2: ESRD in ANCA-positive crescentic IgAN, ANCA-negative crescentic IgAN and ANCA-associated crescentic glomerulonephritis patients (simple random sampling). ANCA, antineutrophil cytoplasmic autoantibody; IgAN, IgA nephropathy; ESRD, end-stage renal disease; GN, glomerulonephritis.
Mentions: Nine out of 20 ANCA-positive IgAN patients were diagnosed with crescentic IgAN. Tables 3 and 4 and Figure 2 show the comparison of clinical and histological data, response to therapy and prognosis among ANCA-positive crescentic IgAN, ANCA-negative crescentic IgAN and ANCA‚Äďassociated crescentic glomerulonephritis patients (simple random sampling).Table 3.

Bottom Line: Histologically, there was a significantly higher percentage of fibrinoid necrosis in glomeruli in ANCA-positive IgAN patients and in AASV patients compared with ANCA-negative IgAN patients (35, 25 and 0%, respectively, P = 0.003).After immunosuppressive therapy, ANCA-positive crescentic IgAN patients were more likely to withdraw from dialysis (75 versus 9.1%, P = 0.03) and not to reach end-stage renal disease within 6 months (11.1 versus 66.7%, P = 0.01) compared with ANCA-negative crescentic IgAN patients.However, renal prognosis was relatively better in ANCA-positive crescentic IgAN patients after aggressive immunosuppressive therapy in the short term, compared with ANCA-negative patients.

View Article: PubMed Central - PubMed

Affiliation: Renal Division, Key Laboratory of Renal Disease, Ministry of Health of China , Peking University First Hospital, Institute of Nephrology, Peking University , Beijing , PR China.

ABSTRACT

Background: The coexistence of IgA nephropathy (IgAN) and antineutrophil cytoplasmic autoantibodies (ANCAs) is relatively rare. Only a few studies have reported the features of these patients.

Methods: We studied the clinical and histological features of 20 ANCA-positive IgAN patients. They were compared with ANCA-negative IgAN patients (n = 40) and ANCA-associated systemic vasculitis (AASV) patients (n = 40) with a randomly selected and matched proportion of crescentic glomeruli. Furthermore, 9 ANCA-positive crescentic IgAN patients out of the 20 cases were compared with two control groups with crescentic nephritis.

Results: ANCA-positive IgAN patients showed older age, lower haemoglobin and higher inflammatory indicator levels at baseline, and a higher percentage of general symptoms and pulmonary involvement, compared with ANCA-negative IgAN patients, and were comparable to AASV patients. Histologically, there was a significantly higher percentage of fibrinoid necrosis in glomeruli in ANCA-positive IgAN patients and in AASV patients compared with ANCA-negative IgAN patients (35, 25 and 0%, respectively, P = 0.003). After immunosuppressive therapy, ANCA-positive crescentic IgAN patients were more likely to withdraw from dialysis (75 versus 9.1%, P = 0.03) and not to reach end-stage renal disease within 6 months (11.1 versus 66.7%, P = 0.01) compared with ANCA-negative crescentic IgAN patients.

Conclusions: IgAN patients with ANCA positivity showed more severe clinical and histological features when compared with ANCA-negative IgAN patients and were comparable to AASV patients. However, renal prognosis was relatively better in ANCA-positive crescentic IgAN patients after aggressive immunosuppressive therapy in the short term, compared with ANCA-negative patients.

No MeSH data available.


Related in: MedlinePlus