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Electron microscopic study of the cases of minimal change nephrotic syndrome with mesangial IgA deposition
H J Jeong1, S H Jung, I J Choi
1Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
Abstract:
Twenty-five cases of minimal change nephrotic syndrome(minimal change disease, MCD) with mesangial IgA deposition were evaluated electron microscopically. The thickness of the glomerular basement membrane(GBM) was 3875 +/- 1271 A and 3056 +/- 1201 A in adults and children, respectively. Alteration of the GBM was noted in 3 adults and eight children: splitting in 4, focal thinning in one, widening of the lamina rara interna in 10, and widening of the lamina rara externa in 4 cases. Minimal mesangial electron dense deposits were found in all but one adult, and an increase of the mesangial matrix and minimal mesangial proliferation were observed in 8 and 6 cases, respectively. Electron microscopic findings show representative findings of MCD in our cases. A relationship between the GBM alterations in these cases and frequent association of hematuria is suggested and discussed.
Insights
Minimal change disease (MCD) with IgA deposits shows glomerular basement membrane alterations. These GBM changes in minimal change nephrotic syndrome may correlate with hematuria, requiring further investigation.
Area of Science:
- Nephrology
- Pathology
- Electron Microscopy
Background:
- Minimal change nephrotic syndrome (MCD) is a common cause of nephrotic syndrome in children and adults.
- Mesangial IgA deposition is an uncommon finding in MCD.
- Electron microscopy is crucial for diagnosing MCD and evaluating glomerular ultrastructure.
Purpose of the Study:
- To investigate the electron microscopic findings in minimal change nephrotic syndrome (MCD) cases with mesangial IgA deposition.
- To analyze glomerular basement membrane (GBM) alterations and their potential relationship with hematuria.
Main Methods:
- Electron microscopic examination of renal biopsies from 25 patients with minimal change nephrotic syndrome and mesangial IgA deposition.
- Quantitative and qualitative assessment of glomerular basement membrane thickness and structural changes.
- Evaluation of mesangial matrix, mesangial proliferation, and electron dense deposits.
Main Results:
- Glomerular basement membrane thickness varied between adults and children.
- Alterations in the GBM, including splitting, thinning, and widening of the lamina rara interna/externa, were observed in a significant proportion of cases.
- Minimal mesangial electron dense deposits, increased mesangial matrix, and mesangial proliferation were also noted.
Conclusions:
- Electron microscopy revealed characteristic findings of MCD in the studied cohort.
- Glomerular basement membrane alterations in these cases of minimal change nephrotic syndrome with IgA deposition are suggested to be associated with hematuria.