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Immunoglobulin M nephropathy (IgMN) affects 11.9% of pediatric renal biopsies in India. Proteinuria and FSGS indicate a poorer prognosis in IgMN cases.

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Area of Science:

  • Nephrology
  • Pediatric Nephrology
  • Immunopathology

Background:

  • Immunoglobulin M nephropathy (IgMN) is a primary glomerulopathy characterized by significant IgM deposition in the renal glomeruli.
  • Understanding the incidence and natural history of IgMN in specific populations, like India, is crucial for diagnosis and management.

Purpose of the Study:

  • To determine the incidence of IgMN in children undergoing renal biopsies in India.
  • To investigate the clinical presentation, histopathological findings, and prognostic factors associated with IgMN in this cohort.

Main Methods:

  • Retrospective evaluation of renal biopsies from children aged 12 years or younger over a 6-year period.
  • Correlation of clinical and biochemical data with histopathological findings.
  • Exclusion of patients with systemic diseases or disorders.

Main Results:

  • IgMN accounted for 11.9% of 236 renal biopsies, with a mean patient age of 10 years, predominantly affecting boys.
  • Proteinuria and edema were the most common clinical presentations.
  • Mesangial proliferative glomerulonephritis (MePGN) was the most frequent histopathological finding (60.7%), followed by minimal change disease (MCD) (28.6%) and focal segmental glomerulosclerosis (FSGS) (10.7%).
  • IgM was the sole immunoglobulin deposit in 85.7% of cases, primarily in mesangial regions.

Conclusions:

  • IgMN represents 11.9% of pediatric renal biopsies, with MePGN, MCD, and FSGS as common associated morphologies.
  • Proteinuria and FSGS were identified as negative prognostic indicators.
  • Co-deposition of other immunoglobulins did not appear to significantly impact the prognosis.