SERUM IMMUNOGLOBULINS IN NEPHROTIC SYNDROME - POSSIBLE CAUSE OF MINIMAL-CHANGE NEPHROTIC SYNDROME
SERUM IMMUNOGLOBULINS IN NEPHROTIC SYNDROME - POSSIBLE CAUSE OF MINIMAL-CHANGE NEPHROTIC SYNDROME
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DOI：
10.1056/nejm197507032930103
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发表时间：
1975-01-01
影响因子：
158.5
通讯作者：
ROBSON, AM
中科院分区：
文献类型：
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作者：
GIANGIACOMO, J;CLEARY, TG;ROBSON, AM
为探讨免疫因素在特发性微小病变型肾病综合征（INS）发病中的作用，测定了37例INS患儿血清免疫球蛋白（Ig）水平，并与36例慢性肾小球肾炎（CGN）继发肾病综合征（NS）患儿进行了比较。肾病综合征和慢性肾小球肾炎患者血清IgG和伊加水平均明显降低，IgG平均分别为正常人的18.5%和25.9%，伊加平均分别为正常人的59.8%和44.1%（P <0.001）。用泼尼松治疗INS后，数值增加，但平均值仍较低。在类固醇成功治疗之前、期间和之后，INS中的血清IgM浓度平均为正常值的两倍以上。CGN患者的血清IgM没有同等升高。因此，INS的主要缺陷可能是免疫缺陷，可能包括介导IgM合成转化为IgG合成的T细胞功能缺陷。（《新英格兰医学杂志》293：8-12，1975）
To assess immunologic factors in the pathogenesis of idiopathic minimal-change nephrotic syndrome (INS), serum immunoglobulin concentrations were measured in 37 children with this syndrome and compared with those found in 36 with nephrotic syndrome secondary to chronic glomerulonephritis (CGN). Serum IgG and IgA levels were significantly reduced in nephrotic patients with either INS or CGN, IgG averaging 18.5 and 25.9 per cent of normal (P <0.001) and IgA 59.8 and 44.1 per cent of normal (P <0.01) respectively. Values increased after treatment of INS with prednisone, but mean values remained low. Serum IgM concentrations in INS averaged more than twice normal before, during and after successful treatment with steroids. Patients with CGN did not have equivalent elevations of serum IgM. Thus, the primary defect in INS may be immunologic and could consist of deficiency in the T-cell function that mediates conversion of IgM synthesis to IgG synthesis. (N Engl J Med 293:8–12, 1975)