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Updated: Jun 27, 2025
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Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
Published on: June 8, 2022
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Hydralazine use can be associated with IgM-dominated immune complex-mediated glomerulonephritis
Ping L Zhang1, Brandon D Metcalf1, Sarang Khan1
1Department of Pathology, Corewell Health (East), Royal Oak, MI, USA.
Ultrastructural Pathology
|April 30, 2024
Summary
Hydralazine can induce autoimmune disorders, leading to IgM-dominant immune complex-mediated glomerulonephritis (IgM-dominant ICMGN). This rare kidney disease presents with specific pathological features and renal dysfunction.
Area of Science:
- Nephrology
- Immunology
- Pathology
Background:
- IgM-dominant immune complex-mediated glomerulonephritis (IgM-dominant ICMGN) is a rare renal disease.
- It is characterized by membranoproliferative patterns, dominant IgM staining, and subendothelial deposits.
Purpose of the Study:
- To investigate the association between IgM-dominant ICMGN and hydralazine-induced autoimmune disorders.
- To analyze the clinicopathologic features of affected patients.
Main Methods:
- Retrospective analysis of seven IgM-dominant ICMGN cases over eight years.
- Detailed examination of pathological phenotypes and clinical scenarios.
Main Results:
- Six of seven patients exhibited drug-induced autoimmune phenomena, specifically hydralazine-induced positive ANCA and ANA.
- All patients presented with renal dysfunction and proteinuria.
- Pathological findings included a membranoproliferative pattern with dominant subendothelial IgM deposits, excluding other glomerulopathies.
Conclusions:
- Hydralazine-induced autoimmune phenomena are observed in some cases of IgM-dominant ICMGN.
- IgM-dominant ICMGN associated with hydralazine should be classified as a subtype of membranoproliferative glomerulonephritis.
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