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IgM mesangial deposition as a risk factor for relapses of adult-onset minimal change disease

Cheng-Wen Yang1,2, Fan-Yu Chen2,3, Fu-Pang Chang3,4

  • 1Division of Nephrology, Department of Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan.

BMC Nephrology
|January 13, 2021
PubMed
Abstract

Insights

Adult minimal change disease (MCD) patients with Immunoglobulin M (IgM) deposition show a higher relapse rate. This finding suggests closer monitoring for these patients to manage disease activity effectively.

Area of Science:

  • Nephrology
  • Immunopathology
  • Clinical Medicine

Background:

  • Immunoglobulin M (IgM) mesangial deposition is linked to steroid dependence and poor outcomes in pediatric minimal change disease (MCD).
  • The prognostic impact of IgM mesangial deposition on treatment response in adult-onset MCD remains unclear.

Purpose of the Study:

  • To investigate the association between IgM mesangial deposition and treatment outcomes in adult-onset MCD.
  • To determine if IgM deposition predicts relapse frequency in adult MCD patients.

Main Methods:

  • Retrospective cohort study of 37 adult MCD patients with kidney biopsies (2010-2020).
  • Patients were categorized based on positive (n=12) or negative (n=25) IgM mesangial deposition via immunofluorescence microscopy.
  • Clinical features, immunosuppressive treatment dosage, and 2-year treatment response were analyzed.

Main Results:

  • No significant differences in clinical symptoms, immunosuppressive treatment dosage, or time to remission were observed between groups.
  • Patients with positive IgM deposition experienced a significantly higher frequency of relapses (0.75 episodes/year) compared to those with negative deposition (0.25 episodes/year).
  • Multivariate regression confirmed IgM mesangial deposition as an independent predictor of increased relapse frequency (B=0.450, p=0.010).

Conclusions:

  • Adult-onset MCD patients with IgM mesangial deposition face an elevated risk of disease relapses.
  • Intensive monitoring for disease activity is recommended for adult MCD patients with IgM mesangial deposition.
  • These findings highlight the importance of identifying IgM deposition for personalized treatment strategies in adult MCD.
Keywords:
Adult-onsetIgM mesangial depositionMinimal change diseaseRelapse

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