CLINICAL-EFFICIENCY OF TYPE-IV COLLAGEN IN EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY

We previously reported a patient who developed anti-glomerular basemen t membrane antibody-induced glomerulonephritis (GBM-GN) after extracor poreal shock wave lithotripsy (ESWL). To determine whether ESWL causes anti-GEM antibody production thereby inducing GBM-GN, we measured ser um levels of type-IV collagen (the most major component of GEM) before and after ESWL. Serum samples were obtained from 13 patients with ren al stones and 15 with ureteral stones. The serum type-IV collagen leve l was determined by a radioimmunoassay method. No significant changes were observed in the type-IV collagen level after ESWL in each patient group. Type-IV collagen was abundant in the GEM but was not released into the blood after ESWL. Therefore, in patients with urinary tract s tones, it is not likely that type-IV collagen, a hidden antigen in the renal glomeruli, is exposed or released into the blood after ESWL, re sulting in autoantibody production and GBM-GN.