Serum immunoglobulin E can predict minimal change disease before renal biopsy.
OBJECTIVE
Minimal change disease (MCD) is a major cause of nephrotic syndrome in both children and adults. The diagnosis of MCD in adults relies on findings of renal biopsy. Complications, although rare, may occur. This invasive procedure is also a suffering experience for some patients. Although Shu et al described the increase of serum immunoglobulin E (IgE) level in patients with MCD, whether IgE could be a predicting factor of MCD has not been determined.


METHODS
The sample was composed of 76 nonlupus patients with nephrotic range (>or=3.5 g/d/1.73 m) proteinuria and normal creatinine level who received renal biopsy since January 2006 to December 2007. Twenty-four demographic, clinical, and laboratory variables as predictors of MCD, including IgG, IgA, IgM, and IgE, were retrospectively gathered by chart review 1 day before renal biopsy.


RESULTS
The overall prevalence of MCD in this group (nonlupus and normal creatinine level) was 27.6% (21 of 76). The independent Student t test identified that 3 of 24 variables is statistically significant (P < 0.05). Serum IgE was found to have a good discriminative power (area under the receiver operating characteristic curve 0.868 +/- 0.053; P < 0.001) according to the area under the receiver operating characteristic curve.


CONCLUSIONS
Serum IgE exhibited high discriminative power in predicting MCD. Serum IgE is a straightforward and easily applied evaluative tool with good predictive abilities.
Shao
Yen-Ning
YN
Department of Nephrology, Renal Research Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan.
Chen
Yung-Chang
YC
Jenq
Chang-Chyi
CC
Hsu
Hsiang-Hao
HH
Chang
Ming-Yang
MY
Tian
Ya-Chung
YC
Fang
Ji-Tseng
JT
Yang
Chih-Wei
CW
D000328:Adult; D001706:Biopsy; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D008297:Male; D009402:Nephrosis, Lipoid / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D007073:Immunoglobulin E