Research Article

Clinicopathological analysis of idiopathic membranous nephropathy in young adults

Published: May 04, 2015
Genet. Mol. Res. 14 (2) : 4541-4548 DOI: https://doi.org/10.4238/2015.May.4.12
Cite this Article:
(2015). Clinicopathological analysis of idiopathic membranous nephropathy in young adults. Genet. Mol. Res. 14(2): gmr5084. https://doi.org/10.4238/2015.May.4.12
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Abstract

The aim of this study was to understand the clinicopath­ological features and prognosis of idiopathic membranous nephropa­thy (IMN) in youth. A retrospective analysis of the clinicopathological features and prognoses of pathologically confirmed IMN in 21 patients aged 15-30 years was performed. IMN was mainly characterized as nephrotic syndrome (NS), with stage I as the main pathological stage, and associated with hyperplasia of the glomerular mesangial cells and ground substance. High-intensity immunofluorescence also showed multi-site deposition of a variety of immune complexes, and electron microscopy showed multi-site deposition of electron-condensing sub­stances. In the present study, 4 patients received non-specific treatment. Among 17 NS patients, 12 patients exhibited a preference for glucocor­ticoid therapy, and of these patients, 7 were sensitive to therapy and 5 were resistant. In the 12 patients who received hormone treatment com­bined with immunosuppressants (including 5 patients who were treated with the combination from the initial start, 5 patients who were steroid resistant, and 2 patients who were sensitive to the initial hormone treat­ment but who later showed relapse), complete remission was achieved in 6 patients, partial remission was achieved in 2, the treatment was ineffective in 2, and 2 patients were lost to follow-up. In conclusion, the clinical manifestation of IMN in youth in this study was mainly NS. In most patients, the initial hormone treatment was effective, and in some patients, the combination of hormone and immunosuppressant treatment was effective. As the sample size in this study was small, further clinical validation is still required to determine the efficacy of the treatment.

The aim of this study was to understand the clinicopath­ological features and prognosis of idiopathic membranous nephropa­thy (IMN) in youth. A retrospective analysis of the clinicopathological features and prognoses of pathologically confirmed IMN in 21 patients aged 15-30 years was performed. IMN was mainly characterized as nephrotic syndrome (NS), with stage I as the main pathological stage, and associated with hyperplasia of the glomerular mesangial cells and ground substance. High-intensity immunofluorescence also showed multi-site deposition of a variety of immune complexes, and electron microscopy showed multi-site deposition of electron-condensing sub­stances. In the present study, 4 patients received non-specific treatment. Among 17 NS patients, 12 patients exhibited a preference for glucocor­ticoid therapy, and of these patients, 7 were sensitive to therapy and 5 were resistant. In the 12 patients who received hormone treatment com­bined with immunosuppressants (including 5 patients who were treated with the combination from the initial start, 5 patients who were steroid resistant, and 2 patients who were sensitive to the initial hormone treat­ment but who later showed relapse), complete remission was achieved in 6 patients, partial remission was achieved in 2, the treatment was ineffective in 2, and 2 patients were lost to follow-up. In conclusion, the clinical manifestation of IMN in youth in this study was mainly NS. In most patients, the initial hormone treatment was effective, and in some patients, the combination of hormone and immunosuppressant treatment was effective. As the sample size in this study was small, further clinical validation is still required to determine the efficacy of the treatment.

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