Serum immunoglobulin E can predict minimal change disease before renal biopsy

Yen-Ning Shao, Yung-Chang Chen, Chang-Chyi Jenq, Hsiang-Hao Hsu, Ming-Yang Chang, Ya-Chung Tian, Ji-Tseng Fang, Chih-Wei Yang
American Journal of the Medical Sciences 2009, 338 (4): 264-7

OBJECTIVES: Minimal change disease (MCD) is a major cause of nephrotic syndrome in both children and adults. The diagnosis of MCD in adults relies on findings of renal biopsy. Complications, although rare, may occur. This invasive procedure is also a suffering experience for some patients. Although Shu et al described the increase of serum immunoglobulin E (IgE) level in patients with MCD, whether IgE could be a predicting factor of MCD has not been determined.

METHODS: The sample was composed of 76 nonlupus patients with nephrotic range (>or=3.5 g/d/1.73 m) proteinuria and normal creatinine level who received renal biopsy since January 2006 to December 2007. Twenty-four demographic, clinical, and laboratory variables as predictors of MCD, including IgG, IgA, IgM, and IgE, were retrospectively gathered by chart review 1 day before renal biopsy.

RESULTS: The overall prevalence of MCD in this group (nonlupus and normal creatinine level) was 27.6% (21 of 76). The independent Student t test identified that 3 of 24 variables is statistically significant (P < 0.05). Serum IgE was found to have a good discriminative power (area under the receiver operating characteristic curve 0.868 +/- 0.053; P < 0.001) according to the area under the receiver operating characteristic curve.

CONCLUSIONS: Serum IgE exhibited high discriminative power in predicting MCD. Serum IgE is a straightforward and easily applied evaluative tool with good predictive abilities.

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