Glomerular Immuno-deposits In Atypical Membranous Nephropathy

Objective:In this retrospective study,we collected clinical data in 6-27 month follow-up and pathology data in atypical membranous nephropathy(AMN)patients To investigate relationship between glomerular immunofluorescence staining and clinical characteristics.Methods:Between January 2016 and September 2017,using direct immunofluorescence,we stained every renal biopsy for immune-type deposits of electron microscope proven atypical membranous nephropathy patients in our hospital.After 6-27months' follow-up,there were fourty patients divided into spontaneous remission group,complete remission group,partial remission group and non-remission group,we also collected 10 AMN patients with autoimmune positive as contrast.We compared glomerular immune-type deposits and clinical data including serum and uria albumin to investigate their correlation.Results:(1)Non-remission group patients were significant older than control group,spontaneous remission group and partial remission group.(2)IgA-positivity were significant lower in non-remission group than other groups,IgM-positivity were significant lower in non-remission group than control group and complete remission group.IgG4-positivity were significant higher in non-remission group than remission group.(3)Serum albumin alternating quantity were significant higher in IgA-positive and IgM-positive groups.(4)There was a tendency that serum albumin alternating quantity were increasing with intensity of IgA or IgM,although there were no significant difference between neighbor groups.Conclusions:Our research shown that aging,IgG4 intensity?2,weak IgA and IgM intensity could be hint to poor effect for glucocorticoid treatment in AMN.Glomerular IgA and IgM positivity could predict the serum albumin change after treatment.There were still difficult to distinguish secondary membranous nephropathy merely based on glomerular immuno-deposits,long term follow-up and regular autoimmune test were necessary.