ESPN 51th Annual Meeting

ESPN 2018


 
Association between serum GDIgA1 and results of kidney biopsy in children with IgA nephropathy and Henoch-Schönlein nephritis.
MALGORZATA MIZERSKA-WASIAK 1 Łukasz Gajewski 2 Karolina Cichoń-Kawa 1 Jadwiga Małdyk 3 Agnieszka Rybi-Szumińska 4 Anna Wasilewska 4 Agnieszka Pukajło-Marczyk 5 Danuta Zwolińska 5 Beata Bieniaś 6 Przemysław Sikora 6 Maria Szczepańska 7 Anna Stelmaszczyk-Emmel 8 Urszula Demkow 8 Małgorzata Pańczyk-Tomaszewska 1

1- DEPARTMENT OF PEDIATRICS AND NEPHROLOGY, MEDICAL UNIVERSITY OF WARSAW, POLAND
2- Student’s Scientific Group at the Department of Pediatrics and Nephrology, Medical University of Warsaw, Poland
3- Department of Pathology, Medical University of Warsaw, POLAND
4- Department of Pediatrics and Nephrology, Medical University of Bialystok, POLAND,
5- Department of Pediatric Nephrology, Wroclaw Medical University, POLAND
6- Department of Pediatric Nephrology, Medical University of Lublin, POLAND
7- SMDZ in Zabrze, Silesian Medical University, Department of Pediatrics, Katowice, POLAND
8- Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw,Poland
 
Introduction:

 GDIgA1 (galactose deficient IgA1) is very important factor in pathogenesis of IgA nephropathy (IgAN) and Henoch-Schönlen nephritis (HSN) and it serum level is higher than in healthy patients. The aim of the study was to assess of the association between serum GDIgA1 and results of kidney biopsy in children with IgAN and HSN.

Material and methods:

 Study population consisted of 41 children (15 IgAN and 26 HSN) and 22 in control group. At baseline and at the end of follow-up we measured proteinuria, haematuria, creatinine and IgA, C3 levels, glomerular filtration rate (GFR). Serum level of GDIgA1 was measured at the follow up. Kidney biopsy findings were evaluated using the Oxford classification (1-changes present, 0-absent: M-mesangial hypercellularity; E-endocapilary hypercellularity; S-segmental sclerosis/adhesion; T-tubular atrophy/interstitial fibrosis T0 0-25%, T1 26-50%, T2>50%) and MEST score was calculate as a sum M, E, S, T and intensity of deposits IgA, IgG, IgM, C1 and C3 (0 to +4) was measured. We divided study group depends on presence of E0/E1, S0/S1, T0/T1 and depends on intensity of deposits IgA in kidney biopsy.

Results:

 No differences were found in proteinuria, hematuria, GFR, IgA and C3 and serum GDIgA1 between groups E0vsE1,S0vsS1 (serum GDIgA1, p=0,09), T0vsT1. Serum GDIgA1 was significantly higher in IgAN and HSN children than in control group (p<0.01) In groups MESTscore=1 vs MESTscore=2 vs MESTscore=3 vs MESTscore=4 we not observed differences in serum level GDIgA1. We not found differences in proteinuria, hematuria IgA and C3 and serum GDIgA1 between groups depending on the intensity of deposits of IgA in kidney biopsy: (+1) vs (+2) vs (+3) vs (+4), GFR was significantly lover in IgA+4 group than in other (p<0.05)

Conclusions:

The prognostic significance of serum GDIgA1 for kidney biopsy in children with IgAN and HSN has not been confirmed, but the study needs further research.