title: Chronic periaortitis associated with membranous nephropathy: clues to common pathogenetic mechanisms.
abstract: Chronic periaortitis (CP) is a rare disease hallmarked by the presence of a periaortic retroperitoneal fibro-inflammatory tissue which can often cause obstructive uropathy. CP is isolated in most cases but it may also be associated with other sclerosing inflammatory and immune-mediated diseases. We here present the case of a patient who was initially diagnosed as having CP and subsequently developed membranous nephropathy and chronic sclerosing sialoadenitis of the right parotid gland. As these conditions were all characterized by either pronounced infiltration of IgG4-positive plasma cells or marked IgG4 tissue deposition, we hypothesize that they are part of the same disease spectrum, and discuss the immune-mediated pathogenetic mechanisms potentially shared by these conditions. In particular, we consider the role of Th2-mediated immune reactions and of immunogenetic factors such as HLA genotype as common determinants of these disorders.
authors.affiliation: Department of Clinical Medicine, Nephrology and Health Science, Section of Histology, University of Parma, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Palmisano
authors.forename: D
authors.initials: D
authors.lastname: Corradi
authors.forename: M L
authors.initials: ML
authors.lastname: Carnevali
authors.forename: F
authors.initials: F
authors.lastname: Alberici
authors.forename: E M
authors.initials: EM
authors.lastname: Silini
authors.forename: R
authors.initials: R
authors.lastname: Gatti
authors.forename: L
authors.initials: L
authors.lastname: Allegri
authors.forename: C
authors.initials: C
authors.lastname: Buzio
authors.forename: A
authors.initials: A
authors.lastname: Vaglio
mesh_terms: D000368:Aged; D001706:Biopsy; D002908:Chronic Disease; D005455:Fluorescent Antibody Technique; D005838:Genotype; D015433:Glomerulonephritis, Membranous / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D005938:Glucocorticoids / Q000008:administration & dosage; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D018613:Microscopy, Confocal; D010305:Parotid Diseases / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D010641:Phenotype; D010950:Plasma Cells / Q000276:immunology; D011241:Prednisone / Q000008:administration & dosage; D012185:Retroperitoneal Fibrosis / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D012598:Sclerosis; D012793:Sialadenitis / Q000150:complications / Q000175:diagnosis / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D006680:HLA Antigens; D007074:Immunoglobulin G; D011241:Prednisone