IgM deposition is a risk factor for delayed remission and early relapse of the pediatric minimal change disease
BackgroundMinimal change disease (MCD) is the most common pathological subtype of pediatric idiopathic nephrotic syndrome (INS). It has been suggested that IgM deposition might predict kidney function deterioration in the course of MCD. However, the specific role of IgM deposition in the prognosis o...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1072969/full |
| _version_ | 1811173046454583296 |
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| author | Tao Ju Yingchao Peng Yaqin Wei Xiaojie Li Meiqiu Wang Ren Wang Xiao Yang Zhiqiang Zhang Chunlin Gao Chunlin Gao Chunlin Gao Chunlin Gao Zhengkun Xia Zhengkun Xia Zhengkun Xia Zhengkun Xia |
| author_facet | Tao Ju Yingchao Peng Yaqin Wei Xiaojie Li Meiqiu Wang Ren Wang Xiao Yang Zhiqiang Zhang Chunlin Gao Chunlin Gao Chunlin Gao Chunlin Gao Zhengkun Xia Zhengkun Xia Zhengkun Xia Zhengkun Xia |
| author_sort | Tao Ju |
| collection | DOAJ |
| description | BackgroundMinimal change disease (MCD) is the most common pathological subtype of pediatric idiopathic nephrotic syndrome (INS). It has been suggested that IgM deposition might predict kidney function deterioration in the course of MCD. However, the specific role of IgM deposition in the prognosis of MCD is still controversial. This study aims to investigate the clinical significance of IgM deposition on delayed remission and early relapse in a pediatric population.MethodsThis study enrolled 283 children diagnosed with MCD by renal biopsy in a single center from 2010 to 2022. These cases were divided into two groups according to the histopathological deposition of IgM. Patients' demographics, clinical parameters, and follow-up data were collected and analyzed. The primary and secondary outcomes were defined as the time to the first remission and the first relapse.ResultsThe IgM-positive group had a weaker response to steroids (steroid-sensitive: 23.5% vs. 40.8%; steroid-dependent: 74.0% vs. 51.0%; steroid-resistant: 18.4% vs. 8.2%, P = 0.001), and showed more recurrent cases (47.2% vs. 34.4%, P = 0.047) compared with the IgM-negative group. The Kaplan-Meier analysis showed that the IgM-positive group had a lower cumulative rate of the first remission (Log-rank, P < 0.001) and a higher rate of the first relapse (Log-rank, P = 0.034) than the IgM-negative group. Multivariate Cox analysis showed that IgM deposition was independently associated with the delayed first remission (hazard ratio [HR] = 0.604, 95% confidence interval [CI] = 0.465–0.785, P < 0.001) and the early first relapse (HR = 1.593, 95% CI = 1.033–2.456, P = 0.035).ConclusionIgM deposition was associated with a weaker steroid response. MCD children with IgM deposition were prone to delayed first remission and early first relapse. |
| first_indexed | 2024-04-10T17:41:28Z |
| format | Article |
| id | doaj.art-c40e8b2d6b9347b28f69474572e1ced4 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-10T17:41:28Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-c40e8b2d6b9347b28f69474572e1ced42023-02-03T13:41:48ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-02-011110.3389/fped.2023.10729691072969IgM deposition is a risk factor for delayed remission and early relapse of the pediatric minimal change diseaseTao Ju0Yingchao Peng1Yaqin Wei2Xiaojie Li3Meiqiu Wang4Ren Wang5Xiao Yang6Zhiqiang Zhang7Chunlin Gao8Chunlin Gao9Chunlin Gao10Chunlin Gao11Zhengkun Xia12Zhengkun Xia13Zhengkun Xia14Zhengkun Xia15Department of Pediatrics, Jinling Hospital, Nanjing Medical University, Nanjing, ChinaAffiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, ChinaDepartment of Pediatrics, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, ChinaAffiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, ChinaAffiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, ChinaDepartment of Pediatrics, Jinling Hospital, Nanjing, ChinaDepartment of Pediatrics, Jinling Hospital, Nanjing, ChinaDepartment of Pediatrics, Jinling Hospital, Nanjing, ChinaDepartment of Pediatrics, Jinling Hospital, Nanjing Medical University, Nanjing, ChinaAffiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, ChinaDepartment of Pediatrics, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, ChinaDepartment of Pediatrics, Jinling Hospital, Nanjing, ChinaDepartment of Pediatrics, Jinling Hospital, Nanjing Medical University, Nanjing, ChinaAffiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, ChinaDepartment of Pediatrics, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, ChinaDepartment of Pediatrics, Jinling Hospital, Nanjing, ChinaBackgroundMinimal change disease (MCD) is the most common pathological subtype of pediatric idiopathic nephrotic syndrome (INS). It has been suggested that IgM deposition might predict kidney function deterioration in the course of MCD. However, the specific role of IgM deposition in the prognosis of MCD is still controversial. This study aims to investigate the clinical significance of IgM deposition on delayed remission and early relapse in a pediatric population.MethodsThis study enrolled 283 children diagnosed with MCD by renal biopsy in a single center from 2010 to 2022. These cases were divided into two groups according to the histopathological deposition of IgM. Patients' demographics, clinical parameters, and follow-up data were collected and analyzed. The primary and secondary outcomes were defined as the time to the first remission and the first relapse.ResultsThe IgM-positive group had a weaker response to steroids (steroid-sensitive: 23.5% vs. 40.8%; steroid-dependent: 74.0% vs. 51.0%; steroid-resistant: 18.4% vs. 8.2%, P = 0.001), and showed more recurrent cases (47.2% vs. 34.4%, P = 0.047) compared with the IgM-negative group. The Kaplan-Meier analysis showed that the IgM-positive group had a lower cumulative rate of the first remission (Log-rank, P < 0.001) and a higher rate of the first relapse (Log-rank, P = 0.034) than the IgM-negative group. Multivariate Cox analysis showed that IgM deposition was independently associated with the delayed first remission (hazard ratio [HR] = 0.604, 95% confidence interval [CI] = 0.465–0.785, P < 0.001) and the early first relapse (HR = 1.593, 95% CI = 1.033–2.456, P = 0.035).ConclusionIgM deposition was associated with a weaker steroid response. MCD children with IgM deposition were prone to delayed first remission and early first relapse.https://www.frontiersin.org/articles/10.3389/fped.2023.1072969/fullIgM depositionminimal change dieasechildrenremissionrelapse |
| spellingShingle | Tao Ju Yingchao Peng Yaqin Wei Xiaojie Li Meiqiu Wang Ren Wang Xiao Yang Zhiqiang Zhang Chunlin Gao Chunlin Gao Chunlin Gao Chunlin Gao Zhengkun Xia Zhengkun Xia Zhengkun Xia Zhengkun Xia IgM deposition is a risk factor for delayed remission and early relapse of the pediatric minimal change disease Frontiers in Pediatrics IgM deposition minimal change diease children remission relapse |
| title | IgM deposition is a risk factor for delayed remission and early relapse of the pediatric minimal change disease |
| title_full | IgM deposition is a risk factor for delayed remission and early relapse of the pediatric minimal change disease |
| title_fullStr | IgM deposition is a risk factor for delayed remission and early relapse of the pediatric minimal change disease |
| title_full_unstemmed | IgM deposition is a risk factor for delayed remission and early relapse of the pediatric minimal change disease |
| title_short | IgM deposition is a risk factor for delayed remission and early relapse of the pediatric minimal change disease |
| title_sort | igm deposition is a risk factor for delayed remission and early relapse of the pediatric minimal change disease |
| topic | IgM deposition minimal change diease children remission relapse |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1072969/full |
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