Glomerular injury in end-stage liver disease - role of circulating IgG and IgM immune complexes

Lawrence S. Milner, Mark T. Houser, Peter C. Kolbeck, Dean L. Antonson, Thomas L. McDonald, Rodney S. Markin, Byers W. Shaw

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


The relationship of IgG- and IgM-bound circulating immune complexes and immune dysfunction to glomerular injury was evaluated in 15 children with end-stage liver disease (ESLD) awaiting liver transplantation. Compared with age-matched controls, children with ESLD had significantly (P<0.01) increased serum IgG, IgA, and IgM levels, as well as IgG- and IgM-bound circulating immune complexes. Furthermore, they showed a significant (P<0.05) depression of C3 and C4 levels compared with controls. Hematuria occurred in 66% of children with ESLD, and the urinary protein/creatinine ratio was also significantly (P<0.01) increased compared with controls (4.65±2.56 vs. 0.16±0.04mg/mg). Light microscopy of renal biopsy tissue obtained from 6 children with ESLD at the time of transplantation demonstrated mesangial proliferation and expansion with basement membrane splitting. This was associated with subendothelial deposits on electron-microscopic examination, compatible with a diagnosis of membranoproliferative glomerulonephritis. By immunofluorescence, deposition of IgG, IgA, and IgM occurred in various combinations with co-deposition of complement fragments. We conclude that membrano-proliferative glomerulonephritis is a common finding in children with ESLD, probably due to entrapment of circulating IgG- and IgM-bound immune complexes.

Original languageEnglish (US)
Pages (from-to)6-10
Number of pages5
JournalPediatric Nephrology
Issue number1
StatePublished - Feb 1993


  • Circulating immune complexes
  • End-stage liver disease
  • Immunoglobulins
  • Membranoproliferative glomerulonephritis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology


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