Tonsillectomy Beneficial In IgAN Patients

Tonsillectomy Beneficial In IgAN Patients

/ April 19, 2014 / Comments Off on Tonsillectomy Beneficial In IgAN Patients / In The News, New Research Findings
This paper adds to the growing collection over many years showing the efficacy of tonsillectomy in the treatment and even reversal of IgAN.
Transplant Proc. 2014 Mar;46(2):607-9. doi: 10.1016/j.transproceed.2013.11.066.

Beneficial Effects of Tonsillectomy for Mesangial Immunoglobulin A (IgA) Deposition and Clinical Outcome in Five Kidney Transplant Patients With Recurrent IgA Nephropathy: Case Report.

Wang Y1, Ichimaru N2, Kyo M3, Kakuta Y4, Okumi M4, Kaimori JY5, Nonomura N4, Fan Y6, Takahara S5.

Author information

  • 1Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Urology and Kidney Transplantation, Affiliated First Hospital, Shanghai Jiaotong University, Osaka, Japan.
  • 2Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, Osaka, Japan. Electronic address: ichimaru@att.med.osaka-u.ac.jp.
  • 3Sakurabashi Iseikai Clinic, Osaka, Japan.
  • 4Department of Specific Organ Regulation (Urology), Osaka University Graduate School of Medicine, Osaka, Japan.
  • 5Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, Osaka, Japan.
  • 6Department of Urology and Kidney Transplantation, Affiliated First Hospital, Shanghai Jiaotong University, Osaka, Japan.

Abstract

INTRODUCTION:

Tonsillectomy has been applied for recurrent immunoglobulin (Ig)A nephropathy (IgAN) in kidney transplantation recipients, but allograft histologic changes after this treatment remain unclear.

METHODS:

Five patients with recurrent IgAN underwent tonsillectomy for persistent proteinuria (average, 397.2 mg/d; >6 months). Six repeated biopsies were taken 33.8 ± 17.1 months after treatment. Glomerular IgA deposition was detected by immunofluorescence staining on frozen tissue. Histologic and clinical data have been collected.

RESULTS:

An average of 11.2 months (range, 6-20) after tonsillectomy, proteinuria decreased to 60.8 ± 49.3 mg/d. Serum creatinine (SCr) slightly decreased (1.33 ± 0.31 before vs 1.24 ± 0.29 after treatment; P > .05). In 5 of the 6 repeated biopsy samples month after tonsillectomy, there was decreased mesangial IgA deposition. Glomerular crescent and endothelial proliferation were no longer found, although there was increased focal sclerosis and adhesion. After tonsillectomy, there were increased interstitial fibrosis and tubular atrophy, with no significant differences in Banff scores.

CONCLUSIONS:

Tonsillectomy can reverse not only persistent proteinuria, but also mesangial IgA deposition in patients with recurrent IgAN. Tonsillectomy may have both favorable clinical and histologic effects in recurrent IgAN after kidney transplantation.

Copyright © 2014 Elsevier Inc. All rights reserved.

 

Want to help? Write one of the authors of this paper and ask them to send an electronic copy of the paper for reading.. an e-print… if you receive on send me a copy and I’ll post it here.

rg_gmail_address_pic

Tags: , , , ,