الفهرس | Only 14 pages are availabe for public view |
Abstract Abstract Background: IgA nephropathy (IgAN) ia an immunopathologic diagnosis based on a renal biopsy, it is characterized by deposits of IgA-containing immune complexes in the mesangium. The true incidence of IgAN is difficult to determine because a renal biopsy is required for diagnosis. Diagnosis of IgAN may not be made in the milder cases or may be delayed until clinical manifestations are severe enough to necessitate this invasive procedure, development of a reliable serologic test for diagnosis of IgAN would be a major advance for early detection and treatment of this condition. Aim of the Work: To assess the validity of serum and urinary galactose-deficient IgA1( Gd-IgA1) as a possible non-invasive diagnostic biomarker of IgAN compared to renal biopsy. Patients and Methods: This cross-sectional study was conducted at Pediatric Nephrology Clinic, Children’s Hospitals, Ain Shams University on 40 patients with recurrent gross glomerular hematuria diagnosed with renal biopsy and divided into two equal groups, group 1 included patients diagnosed with IgAN and group 2 included patients diagnosed with non-IgA glomerular diseases. For measurement of serum and urinary Gd-IgA1 by a novel lectin-independent enzyme-linked immunosorbent assay (ELISA) using an anti-Gd-IgA1 monoclonal antibody (KM55) as a disease-specific biomarker for IgAN in children. Results: There was no statistically significant difference between among age and sex. Serum Gd-IgA1 levels were significantly elevated in children with IgAN compared with children with non-IgA glomerular diseases. The cut-off point to differentiate between IgAN and non IgA glomerular diseases regarding serum Gd-IgA1 was found 240 ng/L with sensitivity of 75%, specificity of 80.0% and area under ROC curve of 80.2%. Serum Gd-IgA1 levels were negatively correlated with Ptn/Creat ratio and total serum IgA. But there was no statistically significant difference between IgAN and non IgA glomerular diseases regarding urinary Gd-IgA1. Conclusion: Serum Gd-IgA1 level is higher in IgAN patients compared to non-IgA glomerular diseases,serum Gd-IgA1 may be used a non-invasive diagnostic biomarker for IgAN. |