The Characteristics Of IgG,C3 And PLA2R In Patients With Idiopathic Membranous Nephropathy

Objective To investigate the clinical and pathological characteristics of the patients with idiopathic membranous nephropathy(IMN),and to explore the meaning of different expression in nephritic tissue including sedimentary intensity of IgG?C3,level of PLA2 R,and serous content of IgG?C3,in an attempt to provide a baseline in evaluating the disease progression of IMN,judging the severity and offering treatment of this disease.Methods Collectting the 99 cases of patients in our hospital in recent 7 years who had received the renal biopsy pathology exmaninatio,and were pathologically dianosised as IMN.Patients were respectively divided into four group according to the different intensity deposition of,IgG and C3,including "-","+","2 +","3 + " group.Based on the contrast expression of PLA2 R,patients were divided into “+”and “-”group.Then Comparing clinical parameter index and pathological characteristics in those groups of IMN patients.Results Based on the date of 99 collected cases,the results indicated that the most common seen pathological changes in patients with IMN is IgG deposition,followed by C3 deposition,and both of them are serious.The severity differed in genders,man often in "2+" group,and female mainly in "1+" group.Also,the IgG and C3 deposition grows as time went by.The increase in IgG and C3 deposition was consistent,but patients with PLA2 R "+" were more serious than the PLA2 R "-" group.The higher IgG deposition and PLA2 R expression in patients,the higher pathological staging.We assume that IgG deposition intensity may be associated with renal tubule lesions and as the complement C3 deposition intensity increased,focal segmental sclerosis and moderate mesangial proliferation takes more accounts.The thickness of basement membrane in kidney PLA2 R expression "+" group was significantly higher than that in "-" group P<0.05.The 24 hours urine protein increases as IgG deposition grows.The eGFR,ALB,complement C4 and C3 levels decreased in patients with severe C3 deposition.PLA2 R possitive group had the higher 24 hours urinary protein,the lower serum propagated and the higher incidence of renal insufficiency than PLA2 R negetive group.Analysising the correlation between IMN patients serum IgG,C3,C4 and other clinical parameters correlation:IMN patients total 24 hours urinary protein was negatively correlated with serum IgG(P < 0.05);Serum IgG was positively correlated with serum albumin,and negatively correlated with TC,TG(P<0.05);TG was positively correlated with serum C3 and C4(P<0.05).Conclusions 1.IgG and C3 deposition in renal tissue of patients with IMN were serious.The deposition of C3 in male was higher than that in female,which suggested that it might be one of the causes of male predilection and severe disease.2.The deposition of IgG and C3 in renal tissue was positively correlated with the onset time of IMN patients,but not with age.3.According to the intensity of IgG and C3,the expression of PLA2 R and the pathological changes of kidney,it is indicated that these indexes have the potential to be a reliable indicator of the severity of the disease.4.The lower the eGFR in patients with IMN whose intensity of C3 deposition is more severe in the renal tissue,and the probability of renal dysfunction was increased in PLA2 R positive patients,indicating that the C3 content and PLA2 R positive in renal tissue were associated with renal damage.5.According to the correlation analysis of serum IgG,C3 and clinical parameters,these indicators may provide valuable reference for IMN therapy.