Immunohistochemical Characteristics of IgG4-Related Tubulointerstitial Nephritis: Detailed Analysis of 20 Japanese Cases | Zendy

Mitsuhiro Kawano | Zendy; Ichiro Mizushima | Zendy; Yutaka Yamaguchi | Zendy; Naofumi Imai | Zendy; Hitoshi Nakashima | Zendy; Shinichi Nishi | Zendy; Satoshi Hisano | Zendy; Nobuaki Yamanaka | Zendy; Motohisa Yamamoto | Zendy; Hiroki Takahashi | Zendy; Hisanori Umehara | Zendy; Takao Saito | Zendy; Takako Saeki | Zendy

Open Access

Immunohistochemical Characteristics of IgG4-Related Tubulointerstitial Nephritis: Detailed Analysis of 20 Japanese Cases

Author(s) -

Mitsuhiro Kawano,

Ichiro Mizushima,

Yutaka Yamaguchi,

Naofumi Imai,

Hitoshi Nakashima,

Shinichi Nishi,

Satoshi Hisano,

Nobuaki Yamanaka,

Motohisa Yamamoto,

Hiroki Takahashi,

Hisanori Umehara,

Takao Saito,

Takako Saeki

Publication year - 2012

Publication title -

international journal of rheumatology

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.8

H-Index - 33

eISSN - 1687-9279

pISSN - 1687-9260

DOI - 10.1155/2012/609795

Subject(s) - immunohistochemistry , nephritis , medicine , pathology

Although tubulointerstitial nephritis with IgG4+ plasma cell (PC) infiltration is a hallmark of IgG4-related kidney disease (IgG4-RKD), only a few studies are available about the minimum number of IgG4+ PC needed for diagnosis along with IgG4+/IgG+ PC ratio in the kidney. In addition, the significance of the deposition of IgG or complement as a reflection of humoral immunity involvement is still uncertain. In this study, we analyzed 20 Japanese patients with IgG4-RKD to evaluate the number of IgG4+ PCs along with IgG4+/IgG+ PC ratio and involvement of humoral immunity. The average number of IgG4+ PCs was 43.8/hpf and the average IgG4+/IgG+ or IgG4+/CD138+ ratio was 53%. IgG and C3 granular deposits on the tubular basement membrane (TBM) were detected by immunofluorescence microscopy in 13% and 47% of patients, respectively. Nine patients had a variety of glomerular lesions, and 7 of them had immunoglobulin or complement deposition in the glomerulus. In conclusion, we confirmed that infiltrating IgG4+ PCs > 10/hpf and/or IgG4/IgG (CD138)+ PCs > 40% was appropriate as an item of the diagnostic criteria for IgG4-RKD. A relatively high frequency of diverse glomerular lesions with immunoglobulin or complement deposits and deposits in TBM may be evidence of immune complex involvement in IgG4-related disease.

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