S. Inaba et al., DECREASE OF MESANGIAL MATRIX AFTER IMMUNOSUPPRESSIVE THERAPY IN CHILDREN WITH REVERSIBLE MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS TYPE-I, Clinical nephrology, 45(4), 1996, pp. 217-225
We followed the course of membrano proliferative glomerulonephritis (M
PGN) type I after immunosuppressive therapy in 10 children. At diagnos
is all patients had abnormal urinary findings. After a mean follow-up
of 14 years all but one patient showed normal urinalysis and renal fun
ction. Glomerular morphometry revealed an increase in the ratio of mes
angial matrix area to glomerular area (M/G%) in all patients. After im
munosuppressive treatment, a second biopsy was performed, which showed
a significantly decreased M/G% in 4 patients. In 3 of the remaining 6
, the mean M/G% was significantly lower in a third biopsy when compare
d with the first. In addition, there was a negative correlation betwee
n M/G% and duration from onset disease to biopsy (r = -0.46, p < 0.05)
. Fifteen biopsies (6 initial and 9 repeat biopsies) were examined for
the staining of various extracellular matrices. In the initial biopsy
type IV collagen, type V collagen and fibronectin were increased in e
xpanded mesangial areas. Type III collagen was found segmentally in a
few biopsies only. M/G% correlated with the grade of type IV collagen,
type V collagen and fibronectin staining. These findings suggest that
a reversible clinical course of MPGN type I in children is paralleled
by a decrease of mesangial matrix expansion.