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C4d deposition and multilayering of peritubular capillary basement membrane in posttransplantation membranous nephropathy indicate its association with antibody-mediated injury

Authors
 B.J. Lim  ;  M.S. Kim  ;  H.J. Jeong  ;  S.I. Kim  ;  Y.S. Kim 
Citation
 Transplantation Proceedings, Vol.44(3) : 619-620, 2012 
Journal Title
 Transplantation Proceedings 
ISSN
 0041-1345 
Issue Date
2012
Abstract
Membranous nephropathy (MN) may develop as recurrence or de novo after transplantation. Recently, autoimmune or alloimmune responses to unspecified glomerular antigens have been considered as a pathogenetic mechanism. To explore the relationship between antibody-mediated injury and posttransplantation MN, we tested C4d positivity using polyclonal antibody in renal allograft biopsy samples diagnosed as posttransplantation MN. A total of 19 cases (16 males and 3 females), including 2 recurrent and 7 de novo forms, were the subject of the study. On light microscopy, stage II was the most common (n = 9). In addition to glomerular capillary immunoglobulin (Ig)G deposits, all but 2 cases having only sclerotic glomeruli were C4d-positive in glomerular capillary walls. Twelve cases were also positive in cortical peritubular capillaries (PTCs): diffuse in 8 cases and focal in 4 cases. Two of 3 cases associated with acute rejection and 3 of 4 cases associated with chronic rejection were PTC C4d-positive. The frequency of C4d positivity in PTCs was significantly higher than that of posttransplantation IgA nephropathy (P = .028). In conclusion, a higher frequency of PTC C4d positivity suggests an involvement of chronic antibody-mediated injury in the evolution of posttransplantation MN.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91960
DOI
10.1016/j.transproceed.2011.12.052
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
김명수(Kim, Myoung Soo) ; 김순일(Kim, Soon Il) ; 김유선(Kim, Yu Seun) ; 임범진(Lim, Beom Jin) ; 정현주(Jeong, Hyeon Joo)
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Full Text
http://www.sciencedirect.com/science/article/pii/S0041134511017143
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