Sera and plasmas from 50 patients with IgA nephropathy (IgA-NP) have been investigated for the presence of cryoglobulin (CG) and cryofibrinogen (CF), respectively, 2-5 cryoprotein determinations being made for each patient. CG was transiently found in 20 of 50 patients (40%), but in none of 20 healthy blood donors, whereas CF was found in 37 of 50 patients (74%) and in 4 of 20 healthy blood donors. The cryoprecipitates were of single and mixed component types. All but 2 of the patients with CF had haematuria. Nearly all of them had histories of long exposure to the cold as manual workers at the onset or recognition of their disease. There was no clinical remission during a 2-to-5-year follow-up if cryoproteinaemia persisted. A certain correlation was detected between the composition of the CP and the renal immunohistological findings. It is suggested that renal deposition of circulating CF or local formation of CF might be responsible for the tubulo-interstitial fibrocellular changes, which are of prognostic importance.

Adolescent↗

PubMed1987

Lymphocyte subpopulations and immunoglobulins in idiopathic thrombocytopenic purpura (ITP).

Data gained from observations of the humoral and cellular immunity of 22 patients with ITP (11 in remission and 11 splenectomised) are presented. The amount of T-lymphocytes according to E-rosetting decreased significantly. In tests performed with monoclonal sera the amount of OKT-4 cells was significantly lower then normal, and the ratio of OKT-4/OKT-8 was also reduced. The C-4 complement fraction showed a significant reduction, and a rise was observed in the three Ig classes. No differences could be found, however, between patients in remission and in relapse, and between the splenectomised cases, those treated with prednisolone, and those who had no such treatment. Apart from the primary role of antiplatelet antibodies that cause thrombopenia, a complex disturbance in immune regulation also occurred in ITP, and this manifested with changes in the T-lymphocyte subpopulations. Its pathological progress still remains to be justified, but the plasma of healthy individuals and gammaglobulin have a favorable effect by blocking their receptors and they result in the cessation of the symptom and thrombocytopenia.

Adult↗

PubMed1987

Tubular proteinuria in IgA glomerulonephritis.

In the renal biopsy samples of some patients with IgA glomerulonephritis (IgA GN), tubulointerstitial changes and a significant correlation between these changes and the serum creatinine levels had been observed earlier. In order to get an insight into the function of the tubules, 45 patients with IgA GN have been examined for proteinuria with special reference to low molecular weight (LMW) proteins, also called tubular proteins using sodium-dodecylsulphate polyacrylamide gel electrophoresis (SDS-PAGE). Thirty-seven of the 45 patients had proteinuria (200-1890 mg/day). On the basis of the middle molecular weight/high molecular weight (MMW/HMW) protein ratio, the proteinuria was non-selective in 28. Twenty-nine patients had 40-200 mg LMW protein/day in the urine. There was a statistically significant correlation between the tubulointerstitial changes seen in the renal biopsy samples (characterized by the tubulointerstitial index) and the tubular proteinuria. On the basis of these results it is suggested that in most patients with IgA GN there is, in addition to the glomerular lesion, also morphological and functional tubulointerstitial damage, which is in connection with the progression of the disease.

Adult↗

PubMed1986