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Glomerular IgG subclasses in idiopathic and malignancy-associated membranous nephropathy

Journal article
Authors Jennie Lönnbro-Widgren
Kerstin Ebefors
Johan Mölne
Jenny Nyström
Börje Haraldsson
Published in Clinical Kidney Journal
Volume 8
Issue 4
Pages 433-439
ISSN 1753-0784
Publication year 2015
Published at Institute of Neuroscience and Physiology
Institute of Biomedicine, Department of Pathology
Institute of Medicine
Pages 433-439
Language en
Links dx.doi.org/10.1093/ckj/sfv049
Keywords Cancer, Glomerulonephritis, Kidney, Membranous nephropathy, Proteinuria, immunoglobulin G4, phospholipase A2, adult, aged, Article, breast cancer, colon cancer, comparative study, controlled study, correlational study, disease association, disease duration, female, follow up, human, human tissue, idiopathic disease, kidney biopsy, kidney cancer, leukemia, lung cancer, lymphoma, major clinical study, male, malignant neoplastic disease, membranous glomerulonephritis, middle aged, mouth cancer, pathogenesis, priority journal, prostate cancer, retrospective study, staining, uterus cancer
Subject categories Cancer and Oncology

Abstract

Background: In idiopathic membranous nephropathy (MN), antibodies directed towards the glomerular phospholipase A2 receptor (PLA2R) have mainly been reported to be of IgG4 subclass. However, the role of the different IgG subclasses in the pathogenesis of MN, both in idiopathic MN and in secondary cases, is still unclear. In this retrospective study, we test the hypothesis that the absence of glomerular IgG4 and PLA2R in patients with MN indicates malignant disease. Methods: The distribution pattern of glomerular IgG subclasses and PLA2Rwas studied in 69 patients with idiopathicMNand 16 patients with malignancy-associated MN who were followed up for a mean of 83 months. Results: A significant correlation between the absence of IgG4 and PLA2R and malignancy-associatedMNwas found. Thus, IgG4 was positive in 45 of 69 patients (65%) with idiopathicMNbut only in 5 of 16 patients (31%) with malignancy-associated MN. The other IgG subclasses did not differ statistically between the groups, IgG2-positivity being present in more than 94% of patients in both groups. Thirty-five of 63 patients (56%) with idiopathic MN and 3 of 16 (19%) patients with malignancy-associated MN had glomerular deposits of PLA2R. Conclusions: We have found that the absence of glomerular IgG4 and PLA2R iscommonin patients with malignancy-associated MN. In our material, IgG2 could not be used as a marker of underlying malignant disease. Finally, neither IgG1 nor IgG3 seems to be involved in the pathogenesis of MN. © The Author 2015.

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