[IgA nephropathy and Henoch-Schönlein purpura nephritis: clinicopathological, histopathological immunohistological, and electronmicroscopical characteristics].
A comparative analysis on clinicopathological, histopathological, immunological and electronmicroscopical characteristics was performed between 57 cases of IgA nephropathy and 20 cases of Henoch-Schönlein purpura nephritis (HSPN). In IgA nephropathy, most cases were discovered incidentally by asymptomatic proteinuria or hematuria, while H-S nephritides were associated with systemic symptoms such as abdominal and joint pain, in addition to purpura. The average age of HSPN was younger than that of IgA nephropathy. Histologically, mesangial cell proliferation with mild enlargement of matrix, focal thickening of glomerular, capillary loop and Bowman's capsule adhesion were much frequent in HSPN, while enlargement of mesangial matrix without mesangial cell proliferation was characteristic to IgA nephropathy and thickening of glomerular capillary loops was less frequent. However, there were no clear differences between HSPN and IgA nephropathy in advanced stage. Immunofluorescent microscopy demonstrated no qualitative dissimilarities in regard to deposition in immunoglobulins, C3, and fibrinogen, except more frequent deposition of these serum component in glomerular capillary loops of HSPN. Electron microscopic observation revealed mesangial massive electron dense deposit (EDD) in IgA nephropathy, while mesangial EDD were small and granular in HSPN. Hemispherical body, which is massive hemispherical EDD protruding to intercapillary space from mesangium, was found in significantly higher percentage in IgA nephropathy. Distribution of EDD in glomerular capillary was focal in either of HSPN and IgA nephropathy. Intramembranous and subepithelial EDD were frequent and extensive in HSPN compared with IgA nephropathy in which capillary EDD was mainly observed in subepithelial portion. Detailed morphological investigations were able to disclose several differences between HSPN and IgA nephropathy. However, these differences were rather quantitative. A common or similar pathogenesis is suggested for HSPN and IgA nephropathy.
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003176:Complement C3 / Q000032:analysis; D005260:Female; D005455:Fluorescent Antibody Technique; D005922:Glomerulonephritis, IGA / Q000276:immunology / Q000473:pathology*; D006801:Humans; D011695:IgA Vasculitis / Q000276:immunology / Q000473:pathology*; D007136:Immunoglobulins / Q000032:analysis; D007678:Kidney Glomerulus / Q000473:pathology / Q000648:ultrastructure; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D009393:Nephritis / Q000473:pathology*
D003176:Complement C3; D007136:Immunoglobulins