Performance evaluation of serum IgG subclass quantification using a SPAPLUS turbidimetric analyzer and comparison with the BNII nephelometer
SCANDINAVIAN JOURNAL OF CLINICAL & LABORATORY INVESTIGATION
Authors: Cho, Eun Hye; Choi, Rihwa; Kang, Eun-Suk; Park, Hyung-Doo
Abstract
IgG consists of four subclasses: IgG1, IgG2, IgG3, and IgG4. Changes in the serum concentration of each subclass reflect different clinical situations, and quantification of each subclass is important to assess patients' clinical states. Herein, we evaluated the analytical performance of the SPAPLUS turbidimetric analyzer (The Binding Site, Birmingham, UK) for IgG subclass. Precision, linearity, comparison with the BNII system (Siemens Healthineers, Erlangen, Germany), and reference interval were assessed according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. The repeatability and within-laboratory precision were within 5% for all IgG subclasses. The coefficient of determination (R-2) was higher than 0.99 for the analytical measurement range in all IgG subclasses. Comparison between SPAPLUS and BNII revealed significant differences in IgG1, IgG3, and IgG4 (p<.0001). IgG1 and IgG4 values were lower in SPAPLUS than BNII. On the other hand, IgG3 values were higher in SPAPLUS than BNII. The SPAPLUS turbidimetric analyzer exhibited good analytical performance for quantification of four IgG subclasses. Because of the differences between SPAPLUS and BNII, follow-up test for disease monitoring should be performed with same instrument.
Renal hypoplasia can be the cause of membranous nephropathy-like lesions
CLINICAL AND EXPERIMENTAL NEPHROLOGY
Authors: Takizawa, Keiichi; Miura, Kenichiro; Kaneko, Naoto; Yabuuchi, Tomoo; Ishizuka, Kiyonobu; Kanda, Shoichiro; Harita, Yutaka; Akioka, Yuko; Horita, Shigeru; Taneda, Sekiko; Honda, Kazuho; Hattori, Motoshi
Abstract
Background Renal hypoplasia (RH) is the most common cause of chronic kidney disease in children. In cases of RH, proteinuria is often induced by glomerular hypertrophy and hyperfiltration that is commonly associated with focal segmental glomerulosclerosis. This study reports the first case series of a possible association between RH and membranous nephropathy (MN). Methods Of the 168 children with RH who visited our department between 1999 and 2017, five with overt proteinuria (>= 1 g/gCr) underwent renal biopsy. We retrospectively reviewed the medical charts and analyzed biopsy specimens using light microscopy (LM), immunofluorescence (IF), and electron microscopy. Results The five children (four boys and one girl) had a median age of 5.5 years at the time of renal biopsy. The median proteinuria was 4.23 g/gCr (range 1.46-14.25), median serum albumin, 2.9 g/dL (range 2.3-3.7), and median estimated glomerular filtration rate, 59.7 mL/min/1.73 m(2) (range 36.7-103.6). LM showed segmental spike formation and mesangial hypercellularity and IF study showed segmental granular immunoglobulin G (IgG) staining (IgG1 and IgG3 dominant) along the capillary loops in all five patients. Electron-dense deposits were observed in the subepithelial and mesangial areas. Thus, the pathological studies showed MN-like lesions in all patients. Conclusion Our study suggests that RH can be the cause of MN-like lesions.