Immune Deposits in Generalised Mesangioproliferative Glomerulonephritis

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Abstract
One hundred and fourteen kidney biopsies from 106 patients with clinical evidence of glomerulonephrilis (GN), and a diagnosis at light microscopy (LM) of generalised mesangioproliferative GN, were examined by immunofluorescent microscopy (IFM) without knowledge of the LM or the clinical findings at the time of investigation. Correlation of the fluorescent findings in the renal corpuscles to the clinical symptoms, and in part the clinical course, showed: 1. a significantly lower frequency of complete remission in patients with deposits of IgG‐IgA/C3, and a higher frequency of complete remission in patients with deposits of IgG‐IgM/C3. 2. that IgG‐IgA/C3 was significantly more commonly localised solely to the mesangium than other deposits, and IgM/C3 was more commonly localised along the basement membrane of the capillary loops than other ***deposits. ***3. that patients with elevated blood pressure and at the same time reduced kidney function all had deposits of immunoglobulin and C3 localised to both the mesangium and the capillary loops in the glomeruli. 4. that those patients treated with corticosteroid and/or cytostatic drugs had a greater tendency to complete remission. 5. that the effect of immunosuppressive treatment was independent of whether glomerular deposits of immunoglobulin and C3 were present or not. Apart from this no significant association was found between immunoglobulin/C3 deposited in glomeruli and the clinical symptoms of GN or the clinical course. In patients presenting with symptoms of GN less than 3 months before biopsy, deposits of properdin were found to be four times more common than in patients where disease was present for more than 3 months before biopsy. Immunoglobulin and C3 were demonstrated together in only 72% of the biopsies, and in 15% neither deposits of immunoglobulin nor C3 were found. The demonstrated deposits of different immunoglobulin combinations in glomeruli could be used as the basis of an immunological classification in patients with mesangioproliferative GN on LM. Any such classification, however, only seems to be on yet another descriptive level with the same correlative problems as the LM diagnosis, because of the lacking relationship of the IFM findings to symptoms, clinical course and results of therapy.