Clinicopathological analysis of MPO-ANCA glomerulonephritis in children on immune cell infiltrates

Abstract

Abstract BACKGROUND The objective of this study was to establish the correlations between renal immune cell infiltration and clinical, laboratory and pathological characteristics in pediatric patients diagnosed with myeloperoxidase (MPO)-antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (AAGN). METHODS The present study aimed at analyzing the correlation between intrarenal immune cell infiltrates and clinical, laboratory, and renal pathological characteristics in pediatric patients diagnosed with MPO-AAGN. RESULTS Neutrophils infiltrates positively moderately correlated with mononuclear cells infiltrates, acute kidney injury (AKI), procalcitonin (PCT), urinary N-acetyl-β-D-glucosidase (NAG) and Pediatric Vasculitis Activity Score (PVAS), interstitial inflammation, tubulointerstitial inflammation score and tubulitis score, and negatively moderately correlated with ANCA renal risk score (ARRS) low-risk group, minimal and mild group in Mayo clinic chronicity score (MCCS) system. Mononuclear cells infiltrates positively moderately correlated with the value of CD4 + T cells and crescent formation, and negatively moderately correlated with normal glomeruli. Bowman's capsule rupture (BCR) positively moderately correlated with neutrophils and mononuclear cells infiltrates. In AAGN, neutrophil infiltrates were a risk factor for acute kidney disease (AKD), while plasma cells infiltrates were a risk factor for chronic kidney disease (CKD) stages 3–5. The renal survival rate in plasma cells infiltrate (+) group was significantly poorer than plasma cells infiltrates (-) group (X2 = 4.527, p = 0.033). CONCLUSIONS Immune cells infiltrate positively correlated with each other, and mainly positively correlated with acute renal tubular and kidney inflammatory lesions in children with MPO-AAGN. In addition, neutrophils and plasma cells infiltrates were associated with the progression of MPO-AAGN in children.