IgA-IgG腎症の免疫学的研究

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タイトル別名
  • Immunological Study of IgA-IgG Nephropathy
  • IgA IgG ジンショウ ノ メンエキガクテキ ケンキュウ

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10 patients with IgA-IgG nephropathy was studied in immunological aspects as compared with 14 patients with membranous nephropathy (MN.). The operated tonsills revealed histologically typical chronic tonsillitis and showed no specific staining except for IgA rich round cell with epithelial staining of secretory piece by immunofluo-rescence (FAT). Renal histological findings of all the patients showed focal proliferative glomerulonephritis. Itt was interesting that eosinophilic and PAS-positive deposits were observed within peripheral me sangial area. Serum IgA was significant increase and normal IgG and IgM as compared with normal control. It was negative to detect circulating anti-IgA and anti-secretory-IgA antibody. Serum IgA and IgG were significant increase as compared with MN. In renal FAT, IgA was the most predominant immunoglobulin in a fashion of mesangial pattern associated with IgG in all patients, but IgM was not deposited distinctly. IgE was deposited in 4 of 7 and secretory piece was not deposited in all the patients. Serum CH50, C3, C4 and C3 activator (C3 a) were no significant value, but the mean of C3 and C3a were relatively low as compared with normal control and MN. In renal FAT, C3 was deposited in 9 of 10 patients associated with C3a in 6 and properdin in. 7. But Clq was deposited in only 3 patients and C4 was not deposited. In comparison with IgA-IgG nephropathy, C3 and properdin were deposited in all the patients of MN. associated with Clq in 8, C4 in 6 and C3a in 7 out of 10 patients. Circulating ani-mesangial antibody, anti-glomerular basement membrane and anti-tubular base-ment membrane antibody were determined, but none of the patients were positive. In the study of coagulation system, all the patients had no abnormality of FDP in blood and urine and showed no fibrin deposition by renal FAT. According to above results, the etiology, the immunopathogenesis and the distinct clinicopathoe logical entity were discussed in IgA-IgG nephropathy.

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