title: Pathological interstitial vascular proliferation adjacent to glomeruli in immunoglobulin a nephropathy.
abstract: We detected an increase in small arterioles around glomeruli, particularly adjacent to tuft adhesive lesions in immunoglobulin A nephropathy (IgAN), for the 1 st time, as far as we know. We labeled these as periglomerular microarterioles (PGMAs). This study aimed to clarify the pathological significance of PGMAs. Sixty-two patients with IgAN and 19 controls with minor glomerular abnormalities without proteinuria were evaluated in this study. The number of PGMAs located between the Bowman's capsule and the adjoining tubules was counted for each glomerulus. The mean number of PGMAs per glomerulus in cases of IgAN was significantly higher than those of the controls (0.530 ± 0.477 vs. 0.240 ± 0.182, P <0.05). Serial sections showed that most of the PGMAs were in contact with adjacent glomeruli (71.8%), through tuft adhesive lesions (52.1%), or the vascular pole (19.7%). By single regression analysis, the number of PGMAs was found to be positively correlated with the incidence of glomerular tuft adhesion, glomerular sclerosis, or the area of interstitial fibrosis in IgAN. By multiple regression analysis, the incidence of glomerular tuft adhesion was found to be the only independent pathological feature to correlate with the number of PGMAs (P = 0.0006). We have noticed the existence of PGMAs around glomeruli as a pathological finding of IgAN. Furthermore, the number of PGMAs was associated with the incidence of tuft adhesive lesion in glomeruli of IgAN although there was no relationship between the presence of PGMAs and clinical parameters including urinary protein excretion or creatinine clearance in the present study.
authors.affiliation: Department of First Integrated Medicine, Division of Nephrology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Honami
authors.initials: H
authors.lastname: Mori
authors.affiliation: Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Nishi
authors.affiliation: University Health Center, Joetsu University of Education, Joetsu, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Ueno
authors.affiliation: Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Naofumi
authors.initials: N
authors.lastname: Imai
authors.affiliation: Department of First Integrated Medicine, Division of Nephrology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Ookawara
authors.affiliation: Department of First Integrated Medicine, Division of Nephrology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Mirishita
authors.affiliation: Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Ichiei
authors.initials: I
authors.lastname: Narita
authors.affiliation: Department of First Integrated Medicine, Division of Nephrology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Tabei
mesh_terms: D005922:Glomerulonephritis, IGA; D006801:Humans; D007678:Kidney Glomerulus; D011507:Proteinuria; D012044:Regression Analysis