IMPORTANZA DELLO STUDIO IMMUNOISTOCHIMICO IN SOGGETTI CON SINDROME NEFROSICA PRESUMIBILMENTE DA LESIONI MINIME CON CORTICO-DIPENDENZA O FACILITA ALLE RECIDIVE

Translated title of the contribution: Importance of immunohistochemical studies in the so-called minimal lesion nephrotic syndrome steroid-dependent or easy relapser

M. Bardare, L. Ghio, A. Edefonti, F. Gaboardi

Research output: Contribution to journalArticlepeer-review

Abstract

The results of immunohistochemical studies in 26 cases of steroid-dependent or easy relapser nephrotic syndrome, are reported. The patients were treated with steroid strictly according to the International Cooperative Study schedule. Material for complete studies for optic and electron microscope, and immunofluorescence was obtained by percutaneous renal biopsies performed with the Edelmann and Greifer technique. Three samples were analysed: the first was stained with E.E., PAS and trichromic and examined at the optic microscope; the second was fixed in 5% glutaraldehyde and examined at the electron microscope. On the third immunohistochemical studies were performed with single anti-immunoglobulin sera (anti-IgC, anti-IgM, anti-IgA, anti-IgD, anti-IgE) anti-complement sera (anti-C3, anti-C4, anti-C1(q)) and anti-fibrinogen sera (Instituto Behring, L'Aquilla, Italia). On the basis of optic findings and selective proteinuria minimal lesions were diagnosed in all cases. However, two distinct groups were recognized on the basis of ultrastructural and, mainly, immunohistochemical findings. The first group (15 cases), was characterized by immunoglobulins and/or complement deposits, while the second group (11 cases) was deposit-free. Among immunoglobulins, IgM were found in the highest number of cases. As far as the site of deposits is concerned, it was mostly diffuse and generalized with involvement of mesangial and/or subendothelial areas. No correlation between deposits and biochemical data was found. However, the presence of deposits was fairly well correlated with the therapeutic response to immunodepressive treatment subsequently introduced. Indeed, cylophosphamide induced a complete remission in 9 out of the 11 deposit-free patients, and only in 11 out of the 15 cases with deposits.

Translated title of the contributionImportance of immunohistochemical studies in the so-called minimal lesion nephrotic syndrome steroid-dependent or easy relapser
Original languageItalian
Pages (from-to)539-549
Number of pages11
JournalRivista Italiana di Pediatria
Volume4
Issue number6
Publication statusPublished - 1978

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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