Clinical and pathological characteristics and outcomes of Chinese patients with primary anti-neutrophil cytoplasmic antibodies-associated systemic vasculitis with immune complex deposition in kidney

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Abstract

Aim

To analyse the clinical and pathological characteristics of Chinese patients with immune complex deposition in kidney in anti-neutrophil cytoplasmic antibodies (ANCA)-positive vasculitis.

Methods

Enrolled in this study are patients with immune complex deposition in kidney in ANCA-positive vasculitis diagnosed in Peking University First Hospital. Their clinical and pathological data were collected and analysed.

Results

Twenty-three patients were eligible. Fifteen patients were with microscopic polyangiitis and eight patients were with Wegener's granulomatosis. The mean age was 48.8 years and with a male/female ratio of 10/13. The interval, between onset of disease and the diagnosis of disease, was 429.6 ± 693.3 days. All patients had clinical evidence of renal involvement. The major immunoglobulin deposited was IgM and the main locations were mesangial and sub-epithelial area. Four patients also presented features of membranous nephropathy and six patients presented features of IgA nephropathy. About 52.2% of patients had hypocomplementaemia. All patients received immunosuppressive therapy and all of them achieved clinical remission. Patients were followed for about 28.8 ± 25.3 months. Nine patients kept clinical remission, nine patients progressed to end-stage renal disease and five patients died. When these patients are compared with patients who had classical pauci-immune vasculitis, they had greater proteinuria (P < 0.05), higher prevalence of hypocomplementaemia (P < 0.05) and greater glomerular cellularity (P < 0.05).

Conclusion

The present study showed that the features of patients with ANCA-associated vasculitis with immune complex deposition in kidney were similar with classical ‘pauci-immune’ vasculitis except for more proteinuria, more hypocomplementaemia and greater glomerular hypercellularity.

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