Galactose-Deficient IgA1 Deposits in Clear Cell Renal Cell Carcinoma-Related Henoch-Schönlein Purpura Nephritis

Yuhong Zhao; Youngki Kim; Milind Junghare; Viral Vakil; Xuesong Su; Faqian Li; Lihong Bu

doi:10.1155/2020/8828336

Galactose-Deficient IgA1 Deposits in Clear Cell Renal Cell Carcinoma-Related Henoch-Schönlein Purpura Nephritis

Case Rep Nephrol. 2020 Aug 22:2020:8828336. doi: 10.1155/2020/8828336. eCollection 2020.

Authors

Yuhong Zhao¹, Youngki Kim², Milind Junghare³, Viral Vakil³, Xuesong Su⁴, Faqian Li⁵, Lihong Bu⁵

Affiliations

¹ Department of Nephrology, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning 110024, China.
² Department of Pediatrics, Division of Pediatric Nephrology, University of Minnesota, Minneapolis, MN 55455, USA.
³ Department of Renal Disease and Hypertension, University of Minnesota, Minneapolis, MN 55455, USA.
⁴ Department of Nephrology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China.
⁵ Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA.

Abstract

Recent studies suggest that galactose-deficient IgA1 (Gd-IgA1) plays a role in the pathogenesis of primary IgA nephropathy (IgAN) and Henoch-Schönlein purpura nephritis (HSPN). Furthermore, immunostaining of KM55, an antibody that identifies Gd-IgA1, may be helpful to differentiate primary IgAN and HSPN from secondary causes of glomerular IgA deposition. We report sequential kidney biopsies of a malignancy-associated HSPN, showing intense glomerular mesangial IgA deposition at the initial kidney biopsy and dramatic decrease in disappearance of glomerular deposits after tumor removal. We demonstrate that the glomerular IgA deposition contains Gd-IgA1, detected by immunostaining of KM55, with similar distribution and intensity to IgA. This suggests that renal Gd-IgA1 deposition may play a role in the pathogenesis of malignancy-associated HSPN.

Publication types

Case Reports