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Nephrol Dial Transplant (2004) 19: 574-579
Nephrol Dial Transplant Vol. 19 No. 3 (c) ERA-EDTA 2004; all rights reserved

Original Article

Distribution of glomerular IgG subclass deposits in malignancy-associated membranous nephropathy

Hiroshi Ohtani1, Hideki Wakui1, Atsushi Komatsuda1, Shin Okuyama1, Rie Masai1, Nobuki Maki1, Akihiro Kigawa1, Ken-ichi Sawada1 and Hirokazu Imai1,2

1The Third Department of Internal Medicine, Akita University School of Medicine, Akita and 2The Department of Nephrology and Rheumatology, Aichi Medical University, Aichi, Japan

Correspondence and offprint requests to: Hiroshi Ohtani, MD, Third Department of Internal Medicine, Akita University School of Medicine, 1-1-1 Hondo, Akita City, Akita 010-8543, Japan. Email: Ohtanih{at}doc.med.akita-u.ac.jp

Background. Several studies have shown a predominant glomerular deposition of IgG4 in patients with idiopathic membranous nephropathy (MN), whereas significant depositions of other IgG subclasses have been shown in patients with lupus-associated MN and bucillamine-induced MN.

Methods. We examined the distribution patterns of glomerular IgG subclass deposits in 10 patients with malignancy-associated MN (M-MN) and in 15 patients with idiopathic MN by immunofluorescence (IF) microscopy.

Results. The glomerular IF intensities of IgG1 and IgG2 were significantly stronger in the malignancy group than in the idiopathic group (P<0.05). In contrast, there were no differences in glomerular IF intensities of IgG3 and IgG4 between the two groups.

Conclusion. Our findings suggest that the distribution patterns of glomerular IgG subclass deposits are different in idiopathic MN and M-MN. The strong IF intensity of glomerular IgG1 and IgG2 in M-MN may provide a possible predictor for this condition.

Keywords: IgG subclasses; immune complex; immunofluorescence; malignancy; membranous nephropathy


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