Renal pathological analysis using galactose-deficient IgA1-specific monoclonal antibody is a strong tool for differentiation of primary IgA nephropathy from secondary IgA nephropathy.

Content Provider	Europe PMC
Author	Lee, Mingfeng Suzuki, Hitoshi Kato, Rina Fukao, Yusuke Nakayama, Maiko Kano, Toshiki Makita, Yuko Suzuki, Yusuke
Abstract	In several cases with IgA nephropathy (IgAN), differential diagnosis is difficult due to the complication with other systemic diseases which can induce secondary IgAN. Recently, we demonstrated that immunostaining with galactose-deficient IgA1-specific monoclonal antibody (KM55 mAb) specifically showed positive in primary IgAN cases. Here, we report four cases which we could make definitive diagnosis by immunohistological analysis using KM55 mAb. The underlying systemic diseases are rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), hepatitis C (HCV) and Crohn’s disease (CD). Renal pathological findings in the four cases revealed mesangial proliferative glomerulonephritis with IgA and C3 deposits. Immunostaining with KM55 mAb was positive for three cases complicated with RA, SLE and CD, respectively. Thus, these three cases were diagnosed as primary IgAN and treated with tonsillectomy and steroid pulse therapy. These three cases finally achieved clinical remission. On the other hand, the case with HCV showed negative for KM55. Finally, we diagnosed as HCV-related nephropathy and successfully treated by antiviral agents. These cases suggested KM55 mAb is a strong tool to differentiate primary IgAN from secondary IgAN.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC7829275&blobtype=pdf
Volume Number	10
DOI	10.1007/s13730-020-00508-3
PubMed Central reference number	PMC7829275
Issue Number	1
PubMed reference number	32676896
Journal	CEN Case Reports [CEN Case Rep]
e-ISSN	21924449
Language	English
Publisher	Springer Singapore
Publisher Date	2020-07-16
Publisher Place	Singapore
Access Restriction	Open
Rights License	Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2020
Subject Keyword	IgA nephropathy Galactose-deficient IgA1 KM55 IgA deposition
Content Type	Text
Resource Type	Article
Subject	Nephrology