title: Significance of broad distribution of electron-dense deposits in patients with IgA nephropathy.
abstract: Immunoglobulin A nephropathy (IgAN) is characterized by mesangial cell proliferation and mesangial expansion with mesangial depositions of IgA. We have found that electron-dense deposits (EDD) are often observed in areas other than paramesangial areas in glomeruli. To compare electron microscopic findings with light microscopic findings and clinical data, we examined the biopsies from 178 patients with IgAN. Patients were divided into two groups: group A had only paramesangial deposits and group B had deposits not only in paramesangial areas but also in other areas. All patients examined in this study had EDD in glomerular paramesangial areas. Thirty-six patients were included in group B. Cellular crescent formation in glomeruli and urinary protein in group B were significantly higher than those in group A (P < 0.01). Serum albumin and estimated glomerular filtration rate (eGFR) in group B were significantly lower than those in group A (P < 0.05). Group B showed a significant positive correlation with histological severity, which is defined in the Japanese Clinical Guidelines on IgAN. In patients with broad distribution of EDD, urinary protein was significantly increased (P < 0.05). Detailed observation of EDD distribution has an impact on evaluation of the disease activity of IgAN.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Gaku
authors.initials: G
authors.lastname: Kusaba
authors.forename: Isao
authors.initials: I
authors.lastname: Ohsawa
authors.forename: Masaya
authors.initials: M
authors.lastname: Ishii
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Inoshita
authors.forename: Miyuki
authors.initials: M
authors.lastname: Takagi
authors.forename: Chiaki
authors.initials: C
authors.lastname: Tanifuji
authors.forename: Kaori
authors.initials: K
authors.lastname: Takahashi
authors.forename: Junichi
authors.initials: J
authors.lastname: Nakamoto
authors.forename: Mitsutaka
authors.initials: M
authors.lastname: Yoshida
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ohi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Horikoshi
authors.forename: Hidetake
authors.initials: H
authors.lastname: Kurihara
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Tomino
mesh_terms: D000328:Adult; D001706:Biopsy; D005260:Female; D005919:Glomerular Filtration Rate; D005920:Glomerular Mesangium / Q000378:metabolism / Q000473:pathology*; D005922:Glomerulonephritis, IGA / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D007678:Kidney Glomerulus / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008854:Microscopy, Electron; D055815:Young Adult