| The Uses of Urinary βig-h3 in Differential Diagnosis of Isolated Microscopic Hematuria |
| Sung Jin Moon, M.D.1, Seung Hyeok Han, M.D.1, Jin Ju Kim2 , Jin Ji Li, M.D.2 , Dong Sub Jeong2 Seung Jae Kwak2, Jung Eun Lee, M.D.1, Dong Ki Kim, M.D.1, Hyun-Wook Kim, M.D.1 Jae Hyun Chang, M.D.1, Dae-Suk Han, M.D.1 and Shin-Wook Kang, M.D.1, 2 |
Department of Internal Medicine1
College of Medicine, Brain Korea 212
Yonsei University, Seoul, Korea |
| 원저 : 고립성 현미경적 혈뇨 환자에서 신장 조직검사 시행 여부의 결정을 위한 요중 βig-h3의 유용성 |
| 문성진1 한승혁1 김진주2 이금희2 정동섭2 곽승재2 이정은1 김동기1 김현욱1 장제현1 한대석1 강신욱1, 2 |
| 연세대학교 의과대학 내과학교실1, Brain Korea 212 |
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| Abstract |
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Purpose : This study was undertaken to elucidate the usefulness of urinary βig-h3 concentrations in differential diagnosis of isolated microscopic hematuria patients.
Methods : Seventy-seven patients, in whom renal biopsy was performed due to microscopic hematuria without proteinuria, were enrolled. The patients were divided into two groups, IgAN group (patients with IgA nephropathy, N=37) and NM group (patients with normal or minor change on renal biopsy, N=40), and the clinical characteristics and laboratory findings were compared between the two groups. TGF-β and βig-h3 concentrations in urine were determined by ELISA and were compared between the two groups. To establish the optimal cut-off value of βig-h3/creatinine (Cr) ratio for the diagnosis of IgA nephropathy, a receiver operating characteristic curve was constructed and the sensitivity and specificity were calculated.
Results : A comparative analysis revealed no significant differences in age and sex ratio between the two groups. There were no differences in serum IgG, IgA, IgM, C3, and C4 levels between the two groups. The urinary βig-h3/Cr ratio was significantly higher in the IgAN group compared to the NM group (6.632.6 vs. 4.462.6 ng/mg, p<0.05), whereas there was no significant difference in the urinary TGF-/Cr ratio between the two groups (14.82.1 vs. 13.75.1 pg/mg, p>0.05). A cut-off βig-h3/Cr ratio 4.5 has a sensitivity of 85.0% and a specificity of 77.8%.
Conclusion : The urinary βig-h3/Cr ratio was a good predictor for the diagnosis of IgA nephropathy. Therefore, renal biopsy should be considered in isolated microscopic hematuria patients with high urinary βig-h3/Cr ratio.
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| Key Words:
Hematuria, Biopsy, IgA nephropathy, TGF-beta, BIGH3 protein |
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