Analysis Of Clinical And Pathological Characteristics Of Patients With ANCA-associated Vasculitis With Glomerular IgA And C3 Deposition

Objective: To investigate the clinical manifestations,renal pathological characteristics and prognosis of patients with anti-neutrophil cytoplasmic antibody-associated vasculitis(AAV)with IgA and C3 deposits in the glomeruli.Methods: Through the collection of general data and clinical manifestations of 65 cases of anti-neutrophilic cytoplasmic antibody related vasculitis(AAV)diagnosed by renal puncture biopsy at the First Affiliated Hospital of Guangxi Medical University from January 2008 to March 2019.Laboratory examination indicators,renal pathology and follow-up data and retrospective analysis.According to the results of renal pathological immunofluorescence test,patients with anti-neutrophilic cytoplasmic antibody related vasculitis(AAV)were divided into positive groups with IgA and C3 deposits and negative groups with no immuno-complex deposition of glomerules.The differences in general data,clinical symptoms,laboratory examination,renal pathology,treatment and prognosis of the two groups were compared.Results: A total of 65 patients with AAV were included in this study,including 9 cases of glomerular iga and C3 deposition group and 56 cases of glomerular non-immune complex deposition group.(1)in laboratory examination,the hemoglobin in IgA and C3 deposition group was lower than that in non-immune complex deposition group(P< 0.026).The levels of serum creatinine and urea nitrogen in the group without immune complex deposition were higher than those in the group without immune complex deposition(P =0.009 and 0.018,respectively).The serum albumin and C-in the two groups were higher than those in the group without immune complex deposition.There was no significant difference in other laboratory indexes such as reactive protein and parathyroid hormone;(2)there was no significant difference in sex,age,fever,fatigue and weight loss between the two groups in terms of general data and clinical manifestations;there was no significant difference between the two groups in terms of sex,age,fever,fatigue and weight loss.(3)Kidney.Histologically,the proportion of glomerulosclerosis in the group with IgA and C3 deposition was significantly higher than that in the group without immune complex deposition.There was statistical significance(P<0.027).(4)in terms of treatment,there was no significant difference in the use of hormones and immunosuppressants between the two groups(P > 0.05).(5)Kaplan-Meier survival analysis showed that the risk of death in IgA and C3 deposition group was 6.059 times higher than that in non-immune complex deposition group(P<0.0375).Conclusion: In patients with ANCA associated vasculitis combined with glomerular IgA and C3 deposits,kidney damage is more prominent than that of the oligo-immune complex ANCA associated vasculitis,and the condition is more serious and the prognosis is worse.