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Croatian Medical Journal, Vol. 58 No. 4, 2017.

Original scientific paper

https://doi.org/10.3325/cmj.2017.58.281

IgM as a novel predictor of disease progression in secondary focal segmental glomerulosclerosis

Arijana Pačić ; Department of Pathology and Cytology, Dubrava University Hospital, Zagreb, Croatia
Petar Šenjug ; Department of Pathology and Cytology, Dubrava University Hospital, Zagreb, Croatia
Jasna Bacalja ; Department of Pathology and Cytology, Dubrava University Hospital, Zagreb, Croatia
Miroslav Tišljar ; Department of Nephrology Dubrava University Hospital, Zagreb, Croatia
Ivica Horvatić ; Department of Nephrology Dubrava University Hospital, Zagreb, Croatia
Stela Bulimbašić ; Department of Pathology and Cytology, Zagreb University Hospital Centre, Zagreb, Croatia
Mladen Knotek ; Department of Nephrology, Merkur University Hospital, Zagreb, Croatia
Krešimir Galešić ; Department of Nephrology Dubrava University Hospital, Zagreb, Croatia
Danica Galešić Ljubanović ; Department of Pathology and Cytology, Dubrava University Hospital, Zagreb, Croatia

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Abstract

Aim To determine the role of immunoglobulin M (IgM)
deposits in clinical manifestations, disease outcome, and
treatment response of idiopathic and secondary focal segmental
glomerulosclerosis (FSGS).
Methods Kidney biopsy specimens of 171 patients diagnosed
with FSGS (primary and secondary) and 50 control
patients were retrospectively included in the study. For
each patient, clinical and outcome data were obtained and
compared to morphological parameters, including immunofluorescence
analysis of mesangial IgM and complement
3 (C3) deposits analyzed on kidney biopsy samples.
Results There were significant positive correlations between
IgM and C3 deposition in secondary FSGS (P < 0.001)
and between IgM and mesangial deposits detected by
electron microscopy in secondary FSGS (P = 0.015), which
indicated that higher IgM deposition correlated with higher
C3 deposition and mesangial deposits only in secondary
FSGS. Patients with secondary FSGS and the deposition of
IgM showed inferior renal outcomes at earlier time points
in comparison with patients with negative IgM expression
(P = 0.022).
Conclusions We detected a positive correlation between
IgM and C3 in secondary FSGS. The association between
IgM deposition and worse renal outcome in secondary
FSGS indicates that IgM may play a role in the progression
of this disease.

Keywords

Hrčak ID:

187402

URI

https://hrcak.srce.hr/187402

Publication date:

10.8.2017.

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