1992 Fiscal Year Final Research Report Summary
Incidence and Mechanism of Hepatic Glomerulonephritis in Children with Chronic Liver Disorders
| Project/Area Number |
02670461
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Pediatrics
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| Research Institution | Juntendo University School of Medicine |
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Principal Investigator |
YABUTA Keijiro Juntendo Univ.Dept of Pediatrics, prof, 医学部, 教授 (30075238)
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| Co-Investigator(Kenkyū-buntansha) |
TUDA Masaharu Juntendo Univ.Dept of Pediatrics, Senior resident, 医学部, 助手 (60146785)
KANEKO Kazunori Juntendo Univ.Dept of Pediatrics, Senior resident, 医学部, 助手 (00214453)
FUKUDA Yutaka Juntendo Univ.Dept of Pediatrics, Senior resident, 医学部, 助手 (40208971)
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| Project Period (FY) |
1990 – 1992
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| Keywords | Biliary Atresia / Biliary Type Liver Cirrhosis / Hepatic Glomerulonephritis |
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| Research Abstract |
We found that some patients with BA, which is one of the advanced liver disorders in childhood, have urinary abnormalities during the course of the illness.
The clinical records of 90 patients with adequate follow-up information were studied, and 40 of them(44.4%) were shown to have hematuria, proteinuria, or both. According to the histological study on 28 autopsied cases, all the kidney specimens showed a wide variety of mesangial proliferation, and lgA was predominantly deposited in most of the casess. It was usually associated with C_3 , likely to form the immune complexes.
There was good correlations between the glomerular alterations and the grade of liver damage or the period of reduced hepatic function. Cases with the history of recurrent cholangitis might show the histological changes in the tubulo-interstitial lesions in addition.
When IgA was present in the mesangium, IgA_2 and secretory components were detected.
Elevated serum IgA and circulating IgA-containing immune complex levels were found in patients with prolonged obstructive jaundice. These findings indicate that IgA of intestinal mucosal origin plays some role in the development of these lesions.
No sings of detorioration in renal function, such as elevation of serum creatinine levels, were observed even in the cases with advanced glomerular alterations. Among several examinations, urinary excretion of microalubumin/ creatinin ratio was most sensitive to detect glomerular damage during the follow-up.
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