EXPANDED PRIMARY T-NODULES IN THE PALATINE TONSILS FROM PATIENTS WITHIGA NEPHROPATHY

We designed a study to investigate the morphological expression of imm une responses in the palatine tonsils from patients with IgA nephropat hy. To distinguish between the histological characteristics of the ton sils in habitual tonsillitis (47 patients) and IgA nephropathy (11 pat ients), we studied the T nodules, B-lymphoid follicles, germinal cente rs, areas of mixed T and B lymphocytes, lacunar epithelium and connect ive tissues; then we compared patients with habitual tonsillitis and I gA nephropathy. The T nodules in patients with IgA nephropathy were en larged, and this change was not accompanied by atrophy of B-lymphoid f ollicles. Morphologically, primary T nodules were predominant. In reac tive lymph nodes, T nodules generally play an important role in the ex tra-follicular maturation of stimulated B lymphocytes into Ig-secretin g plasma cells. Therefore the enlarged primary T nodules remind us tha t this maturation may occur more frequently in the tonsils of patients with IgA nephropathy than in those with habitual tonsillitis. This su ggests that some immunoregulatory dysfunction exists in the secretory immune system of mucosa-associated lymphoid tissues in patients with I gA nephropathy.