Minimal change disease with IgM+ immunofluorescence: a subtype of nephrotic syndrome Export

@article{citeulike:4061763, abstract = {Abstract\ \ Immunoglobulin (Ig) M nephropathy is defined by electron-dense mesangial deposits and mesangial IgM visible by immunofluorescence (IF) without other histopathologic and immunofluorescent microscopic abnormalities. Certain patients have only immuno-positive (IgM+) IF. Children presenting with steroid-dependent or steroid-resistant nephrotic syndrome have a high prevalence of IgM+ IF with or without electron-dense deposits. We reviewed the clinical course of children with steroid-dependent or steroid-resistant nephrotic syndrome who underwent renal biopsy at Texas Children's Hospital from 1989 to 2006 to further characterize IgM+ IF in children with nephrotic syndrome. Of the 55 children with steroid-resistant or -dependent minimal change disease (MCD), 23 had IgM+ IF. Of these 23 children, 61\% had microscopic hematuria at presentation, 48\% (11/23) were steroid-dependent, and 48\% (11/23) steroid-resistant (one underwent biopsy prior to steroid therapy). We compared the efficacy of adjuvant treatment with cyclophosphamide and cyclosporine: 18\% initially treated with cyclophosphamide obtained remission, while 55\% had no response; 83\% obtained subsequent remission with cyclosporine. Of those initially treated with cyclosporine, 88\% obtained complete or partial remission. IgM+ IF may be surrogate marker for the severity of MCD. Based on our results, children with MCD and IgM+ IF have a better response to cyclosporine than cyclophosphamide.}, author = {Swartz, Sarah and Eldin, Karen and Hicks, M. and Feig, Daniel}, citeulike-article-id = {4061763}, citeulike-linkout-0 = {http://dx.doi.org/10.1007/s00467-009-1130-0}, citeulike-linkout-1 = {http://www.springerlink.com/content/f28g25316308h050}, doi = {10.1007/s00467-009-1130-0}, journal = {Pediatric Nephrology}, keywords = {igm-nephropathy, mcd}, posted-at = {2009-02-24 23:41:49}, priority = {0}, title = {Minimal change disease with IgM+ immunofluorescence: a subtype of nephrotic syndrome}, url = {http://dx.doi.org/10.1007/s00467-009-1130-0} }

TY - JOUR ID - citeulike:4061763 L3 - citeulike-article-id:4061763 N2 - Abstract  Immunoglobulin (Ig) M nephropathy is defined by electron-dense mesangial deposits and mesangial IgM visible by immunofluorescence (IF) without other histopathologic and immunofluorescent microscopic abnormalities. Certain patients have only immuno-positive (IgM+) IF. Children presenting with steroid-dependent or steroid-resistant nephrotic syndrome have a high prevalence of IgM+ IF with or without electron-dense deposits. We reviewed the clinical course of children with steroid-dependent or steroid-resistant nephrotic syndrome who underwent renal biopsy at Texas Children‘s Hospital from 1989 to 2006 to further characterize IgM+ IF in children with nephrotic syndrome. Of the 55 children with steroid-resistant or -dependent minimal change disease (MCD), 23 had IgM+ IF. Of these 23 children, 61% had microscopic hematuria at presentation, 48% (11/23) were steroid-dependent, and 48% (11/23) steroid-resistant (one underwent biopsy prior to steroid therapy). We compared the efficacy of adjuvant treatment with cyclophosphamide and cyclosporine: 18% initially treated with cyclophosphamide obtained remission, while 55% had no response; 83% obtained subsequent remission with cyclosporine. Of those initially treated with cyclosporine, 88% obtained complete or partial remission. IgM+ IF may be surrogate marker for the severity of MCD. Based on our results, children with MCD and IgM+ IF have a better response to cyclosporine than cyclophosphamide. JF - Pediatric Nephrology TI - Minimal change disease with IgM+ immunofluorescence: a subtype of nephrotic syndrome KW - igm-nephropathy KW - mcd AU - Swartz, Sarah AU - Eldin, Karen AU - Hicks, M AU - Feig, Daniel UR - http://dx.doi.org/10.1007/s00467-009-1130-0 ER -