SERUM TUMOR-NECROSIS-FACTOR IN MESANGIAL IGA GLOMERULONEPHRITIS WITH MACROSCOPIC HEMATURIA IN CHILDREN

Tumor necrosis factor (TNF)-alpha and interferon (IFN)-gamma levels we re measured in the sera obtained from 29 patients with IgA glomerulone phritis (IgA GN), 8 patients with minimal change nephrotic syndrome (M CNS) and 12 patients with upper respiratory tract infection (URI) with out renal diseases in children. The serum TNF-alpha level of IgA GN wa s 123.0 +/- 175.4 pg/ml, MCNS was 4.9 +/- 4.0 pg/ml and URI was 10.5 /- 4.5 pg/ml respectively. The serum TNF-a level of IgA GN was signifi cantly higher than those of MCNS and URI. The serum TNF-alpha level of URI was on the high trend compared with that of MCNS, but was not sta tistically significant. Although the TNF-alpha level was related to me sangial cell proliferation in patients with IgA GN, it was unrelated t o the grade of mesangial matrix expansion and magnitude of proteinuria . In 17 patients with IgA GN having macroscopic hematuria, the serum T NF-alpha level was 190.5 +/- 201.6 pg/ml, and in other IgA GN patients with microscopic hematuria it was 37.4 +/- 75.7 pg/ml. The serum TNF- alpha level of IgA GN with macroscopic hematuria was significantly hig her than that with microscopic hematuria. In 6 patients with IgA GN wi th macroscopic hematuria, the serum TNF-alpha level was significantly decreased after macroscopic hematuria disappeared. The mean serum IFN- gamma level of IgA GN was 0.3 +/- 0.6 IU/ml, and MCNS was not detectab le. Although the serum IFN-gamma level was related to mesangial cell p roliferation in patients with IgA GN, it was unrelated to magnitude of proteinuria, the grade of mesangial matrix expansion and also the pre sence or absence of macroscopic hematuria. We suggest that macroscopic hematuria of IgA GN was closely related to the serum TNF-alpha level.