Decrease of mesangial matrix after immunosuppressive therapy in children with reversible membranoproliferative glomerulonephritis type I.
We followed the course of membranoproliferative glomerulonephritis (MPGN) type I after immunosuppressive therapy in 10 children. At diagnosis all patients had abnormal urinary findings. After a mean follow-up of 14 years all but one patient showed normal urinalysis and renal function. Glomerular morphometry revealed an increase in the ratio of mesangial matrix area to glomerular area (M/G%) in all patients. After immunosuppressive treatment, a second biopsy was performed, which showed a significantly decreased M/G% in 4 patients. In 3 of the remaining 6, the mean M/G% was significantly lower in a third biopsy when compared with the first. In addition, there was a negative correlation between M/G% and duration from onset disease to biopsy (r = -0.46, p <0.05). Fifteen biopsies (6 initial and 9 repeat biopsies) were examined for the staining of various extracellular matrices. In the initial biopsy type IV collagen, type V collagen and fibronectin were increased in expanded mesangial areas. Type III collagen was found segmentally in a few biopsies only. M/G% correlated with the grade of type IV collagen, type V collagen and fibronectin staining. These findings suggest that a reversible clinical course of MPGN type I in children is paralleled by a decrease of mesangial matrix expansion.
Inaba
S
S
Department of Pediatrics, Toyama Medical and Pharmaceutical University, Japan.
Tanizawa
T
T
Takahashi
T
T
Ishihara
S
S
Arai
M
M
Sakai
Y
Y
Kurose
K K
KK
Matsukura
H
H
Okada
T
T
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002648:Child; D003520:Cyclophosphamide / Q000627:therapeutic use; D004176:Dipyridamole / Q000627:therapeutic use; D005109:Extracellular Matrix / Q000378:metabolism / Q000473:pathology; D016326:Extracellular Matrix Proteins / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D005920:Glomerular Mesangium / Q000378:metabolism / Q000473:pathology*; D015432:Glomerulonephritis, Membranoproliferative / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007165:Immunosuppression Therapy; D008297:Male; D008854:Microscopy, Electron; D008856:Microscopy, Fluorescence; D011239:Prednisolone / Q000627:therapeutic use*; D013997:Time Factors; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use; D014859:Warfarin / Q000627:therapeutic use
D016326:Extracellular Matrix Proteins; D014859:Warfarin; D004176:Dipyridamole; D003520:Cyclophosphamide; D006493:Heparin; D011239:Prednisolone; D014568:Urokinase-Type Plasminogen Activator