Glomerular abnormalities in children undergoing orthotopic liver transplantation.
A prospective study of renal function was undertaken on an unselected group of 8 children with chronic progressive liver disease on whom a renal biopsy was performed subsequently at the time of orthotopic liver transplantation. Two patients had abnormal urinalyses and 2 elevated urinary albumin/creatinine ratios. The remainder had no clinical evidence of renal dysfunction. All had normal serum creatinine concentrations. Glomerular abnormalities were present in all renal biopsies and were of two types: hepatic glomerulosclerosis (n = 5) and minor glomerular abnormalities (n = 3). IgM immunofluorescence was present in all biopsies and IgA in 6. Elevated serum immunoglobulin levels were observed in all patients, with IgM elevation in 6, IgA in 4 and IgG in 6. C3 and/or C4 were reduced in 5 patients and increased circulating immune complexes containing IgM were noted in 4. The clinical significance of these cirrhosis-associated glomerular abnormalities can only be established by long-term follow-up studies after orthotopic liver transplantation.
Chin
S E
SE
Department of Gastroenterology and Nutrition, Royal Children's Hospital, Queensland, Australia.
Axelsen
R A
RA
Crawford
D H
DH
Endre
Z H
ZH
Lynch
S V
SV
Balderson
G A
GA
Strong
R W
RW
Shepherd
R W
RW
Burke
J R
JR
Fleming
S J
SJ
D000419:Albuminuria / Q000378:metabolism; D001706:Biopsy; D002675:Child, Preschool; D003404:Creatinine / Q000652:urine; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D007223:Infant; D007674:Kidney Diseases / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D007678:Kidney Glomerulus / Q000002:abnormalities* / Q000473:pathology; D008107:Liver Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation / Q000473:pathology*; D008297:Male; D011446:Prospective Studies
D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D003404:Creatinine