Idiopathic membranous glomerulonephritis: aspects of geographical differences.

Abstract

SUMMARY Clinicopathological studies of 89 cases of idiopathic membranous glomerulonephritis was carried out to investigate the clinical and histopathological characteristics of the disease. The results were compared with those of previous published reports to observe whether any difference between Japanese and caucasian patients exists. There were no obvious differences as to main clinical features, although an apparently better prognosis in our data was observed during long term follow up. In renal biopsy findings, especially glomerular capillary wall injuries, the prevalence of advanced electron microscopic stages (stages III and IV) was higher in the Japanese cases. A higher rate of clinical remission was observed in the treated group. It was concluded that Japanese cases had an obviously better prognosis despite having more advanced histological findings than the caucasian patients.

Factors affecting the long-term outcomes of idiopathic membranous nephropathy

“…The cause of improved outcomes in our study is unclear and might have resulted from the frequent use of RAAS blockades (75.9%) and immunosuppressive therapies (81.9%). Otherwise, it may support the theory that the clinical course in Asian patients is benign as compared to that in the Caucasian population [19–21]. Through analyses of patients presenting with NS, we showed that maintenance of remission state is important for the preservation of long-term renal function.…”

Association between tongue coating thickness and clinical characteristics among idiopathic membranous nephropathy patients

“…First, diagnostic criteria of idiopathic MN differ from ours to Zeng et al's, which excluded all the cases with glomerular complement 4 (C4) and/or C1q deposition, even with no identified secondary cause. Incidence of idiopathic MN in our study approaches other studies by Abe et al (1986) (Japan), Cahen et al (1989) (France), Honkanen (1986) (Finland), and Gluck et al (1973) (United States), with 65%, 79.3%, 69.8%, 62.3%, respectively. Second, patients with tongue coating score more than 7 and less than 11 were excluded in our study, which might be a reason for the greater incidence of idiopathic MN.…”

Risk HLA-DQA1 and PLA2R1 Alleles in Idiopathic Membranous Nephropathy

“…35 Furthermore, this or other sulfhydryl groups on the extracytoplasmic domains within this molecule could be modified owing to environmental, accidental, or therapyrelated exposure to heavy metals (e.g., gold or mercury), a known cause of secondary membranous nephropathy. [36][37][38][39] We speculate that sequence variants within HLA-DQA1 alleles that are unique to idiopathic membranous nephropathy lead to the presentation of such peptides to immunocompetent cells, resulting in autoantibody formation. Thus, the coexistence of risk alleles in HLA and PLA2R1 in the same person may circumvent the tightly regulated adaptive immune system and allow for the development of idiopathic membranous nephropathy.…”