| Backgroud:The relationship between PLA2 R and IMN has been studied and reported more,but SMN with the positive condition of PLA2 R is less studied.Objective: This study was to investigate the relationship between PLA2 R and HBV-MN.Methods: 1.Retrospective analysis clinical and pathological data of 22 HBV-MN patients who come from the department of nephrology of the First Affiliated Hospital of Fujian Medical University and confirmed by renal biopsy.2.Detect the patients serum anti-PLA2 R antibodies by the use of indirect immunofluorescence.3.The expression of PLA2 R in renal tissue was detected by immunohistochemistry or immunofluorescence.Result: 1.The proportion of male to female is about 17:5,the average age is51.1±10.6years.Systolic blood pressure with maximum up to 168 mm Hg and average to 135.5 ± 16.4 mm Hg,diastolic blood pressure with maximum up to 108 mm Hg and average to 80.9 ± 11.6 mm Hg.Urine protein of 14 cases > 3.5g/24 h and that of 8cases≤3.5g/24 h,the average of urine protein for 24 hours is 5.7±4.9g/24 h,the average of serum albumin is 24.2±5.2g/L.One case has been detected with elevation of serum creatinine when doing renal biopsy,22 cases of HBV-MN patients are all with normal levels of C3.The average of serum total cholesterol was 8.2 ± 2.2mmol/L,the average of triglyceride was 2.2 ± 1.0mmol/L.One patient had elevated ALT.2.The serum PLA2 R antibody was positive in 22 patients with HBV-MN,therein,titer of 6 cases is1:10(+),titer of 8 cases is 1:32(++),titer of 5 cases is 1: 100(+++)and titer of 3 cases is 1: 320(++++).In 22 cases of HBV-MN patients with HBe Ag positive for 0 cases,HBs Ag positive for 4 cases,the remaining 17 cases showed 1 antibody,2 antibodies or3 antibodies were positive,one patient showed hepatitis B serology total negative.There are 12 cases HBV-MN patients have HBV-DNA examination,of which 2patients were positive results.3.Among these 14 cases of HBV-MN patients,there are13cases(92.9%)renal tissue can detect different degrees of PLA2 R deposition,therein,9 cases of strong positive(++++),4 cases of positive(++)/(+++),which appeared to granules or lumps along the glomerular capillary loop,pelvic deposition,one patient(5.6%)renal tissue PLA2 R was negative,another 8 cases of HBV-MN patients who renal tissue PLA2 R and Ig G4 test by immunohistochemical.All of them renal tissue(100%)can detect different degrees of PLA2 R and Ig G4 deposition,therein,3cases of strong positive(++++),4 cases of positive(++)/(+++),1case shows weak positive(+).4.The glomerular basement membrane of all patients appeared to varying degrees of thickening,renal tubular epithelial cells appears to particles,vacuolar degeneration,with tubule atrophy,lumen with visible protein tube type,renal interstitium with visible lymph,monocyte infiltration,14 patients with HBV-MN(63.6%)appeared to different degrees of proliferation of mesangial and mesangial stroma,13 cases of HBV-MN patients(59.1%)appeared to glomerular sclerosis,peritoneal adhesions or fibrosis changes,9 cases of HBV-MN patients(40.9%)appeared to varying degrees of interstitial fibrosis and other lesions.Conclusion: Whether serum HBV antigen negative or positive HBV-MN patients,can exist both serum anti-PLA2 R antibody positive and renal tissue PLA2 R positive expression. |
