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IgM nephropathy: is it closer to minimal change disease or to focal segmental glomerulosclerosis?
R Brugnano1, R Del Sordo2, C Covarelli2
1Department of Nephrology and Dialysis, S. Maria della Misericordia Hospital, Piazza Menghini, 1, San Sisto, 06156, Perugia, Italy. rbrugnano@libero.it.
Abstract:
Immunoglobulin (Ig)M nephropathy (IgMN), known since 1978, is a very controversial clinicopathological entity characterized by IgM diffuse deposits in the mesangium at immunofluorescence whereas light microscop identifies minimal glomerular lesion, hypercellularity and expansion of the mesangium or sclerotic focal, segmental lesion. Clinically, it is a nephrotic syndrome, especially in pediatric patients, or asymptomatic proteinuria and/or isolated hematuria. These characteristics narrowly define IgMN between minimal change disease and focal segmental glomerulosclerosis, so it is not often recognized as a separate pathology. Homogeneous epidemiologic, pathogenetic, clinical or histological data are not available. Recent research on the pathogenetic role of mesangial IgM has, however, renewed interest in IgMN and naturally the controversies.
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