Nephropathy associated with sickle cell anemia: An autologous immune complex nephritis : I. Studies on nature of glomerular-bound antibody and antigen identification in a patient with sickle cell disease and immune deposit glomerulonephritis - 07/10/17

Doi : 10.1016/0002-9343(75)90604-X

Jose Strauss, M.D. ^{^{3
From the Department of Pediatrics, University of Colorado Medical Center, Denver, Colorado.},}^{^{1
From the Departments of Pediatrics and Pathology, University of Miami School of Medicine, Miami, Florida.}}, Victoriano Pardo, M.D. ^{^{1
From the Departments of Pediatrics and Pathology, University of Miami School of Medicine, Miami, Florida.},}^{^{3
From the Department of Pediatrics, University of Colorado Medical Center, Denver, Colorado.}}
Miami, Florida, USA

Michael N. Koss, M.D. ^{^{3
From the Department of Pediatrics, University of Colorado Medical Center, Denver, Colorado.},}^{^{2
From the Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York.}}, William Griswold, M.D. ^{^{3
From the Department of Pediatrics, University of Colorado Medical Center, Denver, Colorado.},}^{^{2
From the Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York.},}^{^{∗
Present address: U.S. Naval Hospital, San Diego, California 92037.}}, Rawle M. McIntosh, M.D. ^{^{2
From the Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York.},}^{^{3
From the Department of Pediatrics, University of Colorado Medical Center, Denver, Colorado.},}^⁎,^{^{†
Present address: Box 2741, The B. F. Stolinsky Research Institute, University of Colorado Medical Center, 4200 E. Ninth Avenue, Denver, Colorado 80220.}}
New York, New York, USA

^∗Requests for reprints should be addressed to Dr. Rawle M.

Abstract

The nature of the glomerular-bound antibody and the putative antigen was investigated in one of the patients with sickle cell disease and immune deposit membranoproliferative glomerulonephritis by immunohistologic and glomerular antibody elution. Renal proximal tubular epithelial antigen was localized in association with immunoglobulins G (IgG), M (IgM), Clq fraction of the first component of complement (Clq) and the third component of complement (C₃) in a granular pattern along the glomerular basement membrane of the patient's kidney. IgG and IgM were eluted from glomeruli. These immunoglobulins fixed to the proximal tubules of normal human kidney by direct immunofluorescence. This localization was abolished by absorption of the eluted immunoglobulins with renal tubular epithelial (RTE) antigen. The IgG eluted from the glomeruli blocked the fixation of rabbit anti-RTE antigen to normal proximal tubular brush border. These studies suggest that the nephritis in this patient was due to deposition of complexes of RTE antigen and specific antibody. An autologous immune complex nephritis may develop in some patients with sickle cell anemia secondary to RTE antigen released possibly after renal ischemia or some other phenomenon causing renal tubular damage.

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☆

This work was performed during the tenure of an Established Investigatorship from the American Heart Association (R.M.M.) and was supported by U.S. Public Health Service Training Grant HD 0051 (W.G.), a Fellowship grant from the New York Heart Association (M.N.K.), a grant-in-aid from the New York Heart Association and the Miami Dolphins Wive's Club through the Dade County Affiliate of the National Kidney Foundation and the Rocky Mountain Kidney Foundation.

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Vol 58 - N° 3

P. 382-387 - mars 1975 Retour au numéro

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Clinical experience with transfusion of granulocytes obtained by continuous flow filtration leukopheresis
Charles A. Schiffer, D.H. Buchholz, Joseph Aisner, Susan W. Betts, Peter H. Wiernik

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Nephropathy associated with sickle cell anemia: An autologous immune complex nephritis : I. Studies on nature of glomerular-bound antibody and antigen identification in a patient with sickle cell disease and immune deposit glomerulonephritis - 07/10/17

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