Clinical and immunopathological analysis of patients with tumor-associated membranous nephropathy #br#
DONG He１ FENG Zhe2▲
1.Department of Hemodialysis, Beijing Fengtai Hospital, Beijing 100071, China;
２.Department of Nephrology, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
Abstract：Objective To investigate the differences of clinical and pathological features in patients with tumor-associated membranous nephropathy, so as to guide clinical practice. Methods A retrospective analysis of 102 patients with membranous nephropathy was performed in the Department of Nephrology, People’s Liberation Army General Hospital from January 2017 to December 2018. According to the etiology, they were divided into idiopathic group (91 cases) and tumor group (11 cases), followed up for 24 months. The general clinical data of the two groups were compared, including age, gender, smoking, hypertension, hematuria, and serous cavity effusion, etc.; laboratory tests: 24-hour urine protein quantification, serum albumin, serum creatinine, serum complement C3, C4, serum anti-phospholipase A2 receptor (PLA2R) antibody, etc. renal pathology including membranous nephropathy stage, renal interstitial inflammatory cell infiltration grade, renal tubular atrophy, immunofluorescence IgG1, and IgG4 deposition were recorded. Results The age of the tumor group was higher than that of the idiopathic group, and the difference was statistically significant (P ＜ 0.05). The degree of renal tubular atrophy in the tumor group was higher than that in the idiopathic group, and the difference was statistically significant (P ＜ 0.05). There were no significant differences in the positive rate of IgG4 deposition and the positive rate of anti-PLA2R antibody between the two groups (P ＞ 0.05). Conclusion The positive rate of IgG4 subtype and whether the anti-PLA2R antibody is positive still need to be cautious in distinguishing membranous nephropathy from tumors. In patients with membranous nephropathy with relatively less severe renal tubular damage, potential tumors should be carefully excluded.
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