Use of C4d as a diagnostic tool to classify membranoproliferative glomerulonephritis.
Background: Membranoproliferative glomerulonephritis (MPGN type I, II and III) was reclassified in 2013 as MPGN and C3 glomerulopathy (C3G) based on the complement system activation mechanism. Objectives: To evaluate whether C4d, a component of the classical pathway, could be a diagnostic tool in di...
| Publicado en: | Nefrología Vol. 37; no. 1; pp. 78 - 87 |
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| Autores principales: | , , , |
| Formato: | Artículo |
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Revista Nefrologia
ene/feb2017
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| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=lth&AN=121304035&site=ehost-live header: @attributes: shortDbName: lth uiTerm: 121304035 longDbName: MedicLatina uiTag: AN controlInfo: bkinfo: jinfo: jid: 02116995 50C3 jtl: Nefrología issn: 02116995 maglogo: N pubinfo: dt: ene/feb2017 vid: 37 iid: 1 pid: 39358 pub: Revista Nefrologia artinfo: ui: 121304035 10.1016/j.nefro.2016.05.011 ppf: 78 ppct: 9 formats: fmt: @attributes: type: P size: 1.2MB tig: atl: Use of C4d as a diagnostic tool to classify membranoproliferative glomerulonephritis. aug: au: Gupta, Nirupama Wakefield, Dara N. Clapp, William L. Garin, Eduardo H. affil: Division of Nephrology, Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL 32610, USA Division of Pathology, Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA su: Glomerulonephritis Peroxidase Lectins Pathology Diseases sug: subj: Glomerulonephritis Peroxidase Lectins Pathology Diseases keyword: C3 glomerulopathy C4d Complement Membranoproliferative glomerulonephritis Complemento Glomerulonefritis membranoproliferativa Glomerulopatía C3 Patología ab: Background: Membranoproliferative glomerulonephritis (MPGN type I, II and III) was reclassified in 2013 as MPGN and C3 glomerulopathy (C3G) based on the complement system activation mechanism. Objectives: To evaluate whether C4d, a component of the classical pathway, could be a diagnostic tool in differentiating between MPGN and C3G. Methods: We conducted a retrospective study of 15 MPGN type I, II and III and 13 minimal change disease (MCD) patients diagnosed between 2000 and 2012. C4d staining using the peroxidase method was employed. Results: Using the 2013 C3G consensus classification, the 15 MPGN types I, II and III biopsies were re-classified as MPGN (8) and C3G (7). Following C4d staining, of the 8 biopsies diagnosed as MPGN, 4 had classical pathway involvement [C1q (+), C3 (+), C4d (+)]; two had lectin pathway involvement [C1q (-), C3 (+), C4d (+)]; and, two were reclassified as C3G because the absence of C4d and C1q suggested the presence of the alternative pathway [C1q (-), C3 (+), C4d (-)]. Three of the seven C3G biopsies presented classical pathway involvement and were reclassified as MPGN. The alternative pathway was present in one of the other 4 biopsies considered to be C3G. Two C3G biopsies involved the lectin pathway and the one case of dense deposit disease had lectin pathway involvement. Conclusions: C4d staining may help to differentiate between MPGN and C3G. In addition, the lectin pathway could play a role in the pathogenesis of these glomerulopathies. Antecedentes: La glomerulonefritis membranoproliferativa (GnMP, tipo I, II y III) fue reclasificada en 2013 como GnMP y glomerulopatía C3 (GC3) en base al mecanismo que activa el sistema del complemento. Objetivos: Evaluar si C4d, componente de la vía clásica, puede diferenciar GnMP y GC3. Métodos: Estudio retrospectivo incluyendo 15 pacientes con GnMP (tipo I, II y III) y 13 con enfermedad de cambios mínimos (CM) diagnosticados entre 2000 y 2012. Realizamos tinción renal con C4d mediante el método de la peroxidasa. Resultados: En base a la definición de GC3 consensuada en 2013, las 15 biopsias diagnosticadas como GnMP se reclasificaron como GnMP y GC3 en 8 y 7 casos respectivamente. Tras la tinción de C4d; de las 8 biopsias diagnosticadas como GnMP, 4 mostraron activación de la vía clásica [C1q (+), C3 (+), C4d (+)], 2 activación de la vía de las lectinas (VL) [C1q (-), C3 (+), C4d (+)]; y 2 fueron reclasificadas como GC3 dada la ausencia de C4d y C1q sugiriendo participación de la vía alternativa [C1q (-), C3 (+), C4d (-)]. Tres de 7 biopsias diagnosticadas de GC3fueron reclasificadas como GnMP debido a las presencia de activación de la vía clásica. La vía alternativa estuvo presente in 1 de las otras 4 biopsias consideradas GC3. VL estuvo activada en 2 de biopsias diagnosticadas de GC3 y en el único caso de enfermedad de depósitos densos. Conclusiones: C4d puede ayudar a diferenciar GnMP y GC3. La VL podría jugar un papel en la patogenia de estas glomerulopatías. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: Y custom: Copyright of Nefrología is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. item: Nefrología holder: Revista Nefrologia dt: @attributes: year: 2017 holdings: @attributes: islocal: N |
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