Glomerular injury in end-stage liver disease - role of circulating IgG and IgM immune complexes

Lawrence S. Milner, Mark T. Houser, Peter C. Kolbeck, Dean L. Antonson, Thomas L McDonald, Rodney Smith Markin, Byers W. Shaw

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

The relationship of IgG- and IgM-bound circulating immune complexes and immune dysfunction to glomerular injury was evaluated in 15 children with end-stage liver disease (ESLD) awaiting liver transplantation. Compared with age-matched controls, children with ESLD had significantly (P<0.01) increased serum IgG, IgA, and IgM levels, as well as IgG- and IgM-bound circulating immune complexes. Furthermore, they showed a significant (P<0.05) depression of C3 and C4 levels compared with controls. Hematuria occurred in 66% of children with ESLD, and the urinary protein/creatinine ratio was also significantly (P<0.01) increased compared with controls (4.65±2.56 vs. 0.16±0.04mg/mg). Light microscopy of renal biopsy tissue obtained from 6 children with ESLD at the time of transplantation demonstrated mesangial proliferation and expansion with basement membrane splitting. This was associated with subendothelial deposits on electron-microscopic examination, compatible with a diagnosis of membranoproliferative glomerulonephritis. By immunofluorescence, deposition of IgG, IgA, and IgM occurred in various combinations with co-deposition of complement fragments. We conclude that membrano-proliferative glomerulonephritis is a common finding in children with ESLD, probably due to entrapment of circulating IgG- and IgM-bound immune complexes.

Original languageEnglish (US)
Pages (from-to)6-10
Number of pages5
JournalPediatric Nephrology
Volume7
Issue number1
DOIs
StatePublished - Feb 1 1993

Fingerprint

End Stage Liver Disease
Antigen-Antibody Complex
Immunoglobulin M
Immunoglobulin G
Wounds and Injuries
Immunoglobulin A
Membranoproliferative Glomerulonephritis
Hematuria
Glomerulonephritis
Basement Membrane
Liver Transplantation
Fluorescent Antibody Technique
Microscopy
Creatinine
Transplantation
Electrons
Kidney
Biopsy
Light
Serum

Keywords

  • Circulating immune complexes
  • End-stage liver disease
  • Immunoglobulins
  • Membranoproliferative glomerulonephritis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

Cite this

Glomerular injury in end-stage liver disease - role of circulating IgG and IgM immune complexes. / Milner, Lawrence S.; Houser, Mark T.; Kolbeck, Peter C.; Antonson, Dean L.; McDonald, Thomas L; Markin, Rodney Smith; Shaw, Byers W.

In: Pediatric Nephrology, Vol. 7, No. 1, 01.02.1993, p. 6-10.

Research output: Contribution to journalArticle

Milner, Lawrence S. ; Houser, Mark T. ; Kolbeck, Peter C. ; Antonson, Dean L. ; McDonald, Thomas L ; Markin, Rodney Smith ; Shaw, Byers W. / Glomerular injury in end-stage liver disease - role of circulating IgG and IgM immune complexes. In: Pediatric Nephrology. 1993 ; Vol. 7, No. 1. pp. 6-10.
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