1479 IMMUNE DEPOSITS IN MINIMAL CHANGE NEPHROTIC SYNDROME (MCNC)CLINICAL RELEVANCE

Abstract

MCNS has been described as having negative immunofluorescence and no immune deposits on electron microscopy. Occasional patients with nephrotic syndrome (NS) and minimal histologic change demonstrate glomerular deposition of small amounts of immunoglobulin and complement. Some consider patients with NS, mesangial hypercellularity and evidence of immune deposits as a separate disease entity. To investigate the clinical importance of the findings of mesangial hypercellularity and immune deposits on the initial biopsy, the clinical records, follow-up data and renal biopsy of 68 patients (ages 6 mos-16 yrs) with MCNS by light microscopy were reviewed. Clinical classification utilized criteria of the International Study of Kidney Disease in Childhood. Among patients with immune deposits present there was a 16-fold increase in the frequency of steroid non-response at follow-up (mean 6.2 yrs). Frequent relapse was noted less often with normal mesangial cellularity. The data suggest that in children with NS and minimal light microscopic change evidence of immune deposits and increased mesangial cells are predictive of clinical course.