Mesangial Proliferative Glomerulonephritis with or without IgA Deposits: The Morphological Characters in Psoriasis Vulgaris

Abstract

Background/Aim: Chronic glomerulonephritides associated with psoriasis vulgaris have been reported in the literature. However, because of the limited number of cases and the lack of specific histological findings, the existence of psoriatic nephropathy remains controversial. This study was performed to investigate the clinical and morphological characteristics of renal involvement in psoriasis vulgaris. Methods: We studied retrospectively 11 patients with psoriasis vulgaris. All patients had nephritic urinary sediments and underwent percutaneous renal biopsy between January 1997 and December 2006. To fulfill the criteria for the study, none of them had any other discernible chronic disease as a second cause of nephropathy, except for long-standing psoriasis vulgaris. Results: Of the 11 patients, 2 (18%) had impaired renal function and 9 (82%) presented with hematuria. Proteinuria was noted in all patients. Their mean peak ESR was 28.3 ± 29.1 mm/1st h. Renal biopsy specimens revealed common histological features of slight-to-moderate mesangial proliferative glomerulonephritis, with (73%) or without IgA depositions in the mesangial area. Inflammation and vascular lesions were unremarkable in the biopsy specimens. Conclusion: The results from this study demonstrate that mesangial proliferative glomerulonephritis with or without IgA deposits might be the major morphological pattern associated with psoriasis vulgaris.

Increased risk of glomerulonephritis and chronic kidney disease in relation to the severity of psoriasis, concomitant medication, and comorbidity: a nationwide population-based cohort study

“…[40][41][42][43][44] Minimal nephrotic syndrome changes were also shown to precede or occur simultaneously with psoriasis in a case series of children. [40][41][42][43][44] Minimal nephrotic syndrome changes were also shown to precede or occur simultaneously with psoriasis in a case series of children.…”

“…Prior small case studies have suggested that various types of GN, such as IgA nephropathy, membranous glomerulopathy and focal segmental glomerulonephritis, may be more likely to occur in patients with psoriasis. [40][41][42][43][44] Minimal nephrotic syndrome changes were also shown to precede or occur simultaneously with psoriasis in a case series of children. 45 Moreover, because GN may progress to CKD or late stage CKD (ESRD) and the diagnosis of CKD is made on the basis of abnormal urinalysis and glomerular filtration rate results without knowledge of the specific cause, 46 we further investigated the relationship among GN, ESRD and psoriasis.…”

PLA2R antibodies and PLA2R glomerular deposits in psoriasis patients with membranous nephropathy

“…Nephropathy associated with psoriasis has been increasingly reported in recent years. These kidney diseases include IgA nephropathy [29, 30], MN [11–14], membranoproliferative glomerulonephritis [31], focal segmental glomerulosclerosis [32], minimal change disease [33], AA-amyloidosis [34], and therapy-related tubular-interstitial alteration [26]. …”

Membranoproliferative Glomerulonephritis Associated with Psoriasis Vulgaris

“…[7,8] Elevations in inflammatory markers such as CRP have also been associated with renal involvement. [10,17] However, these studies have not been confirmed through further investigations.…”

“…[9] However, pathological evidences supporting any immunologic mechanisms common for these two entities have not been demonstrated yet. [10] Other glomerular lesions including membranous glomerulopathy and nephropathies due to nephrotoxic effects of systemically active medications administered for the treatment of psoriasis are quite rare in psoriatic patients. [11][12][13][14] The exact pathogenetic mechanisms of these entities remain unclear because of the limited number of cases.…”