{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T19:59:19Z","timestamp":1759694359531},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2012,8,26]],"date-time":"2012-08-26T00:00:00Z","timestamp":1345939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:title>ABSTRACT:<\/jats:title><jats:p><jats:bold>Aim:\u2003<\/jats:bold> We investigated efficacy and therapeutic mechanisms of tonsillectomy for intractable childhood IgA nephropathy. Five patients refused tonsillectomy. Among 25 patients, 19 patients were able to evaluate histological findings before and after surgery. Patients with poor (<jats:italic>n<\/jats:italic>\u2003=\u20037) or relatively poor (<jats:italic>n<\/jats:italic>\u2003=\u200318) histologically determined prognosis and an age of at least 7\u2003years, together with proteinuria of at least 0.3\u2003g\/day or severe persisting despite ongoing drug treatment, are candidates for surgery. Patients were grouped by interval between diagnosis of IgA nephropathy and tonsillectomy (within 3\u2003years; early group <jats:italic>vs<\/jats:italic> 3\u2003years or later; later group). Patients underwent kidney biopsy shortly before and 1 to 2\u2003years after tonsillectomy.<\/jats:p><jats:p><jats:bold>Results:\u2003<\/jats:bold> Proteinuria was reduced after tonsillectomy over 2\u2003years of follow\u2010up in both early and later groups compared with proteinuria in the 6\u2003months preceding surgery. Complete remission was achieved in 10 patients, most often among those having surgery within 3\u2003years, while patients refusing surgery failed to attain complete remission of urinary findings. Histological activity decreased in both groups, significantly when surgery was early. Complement component C3 deposition and activated macrophages in glomeruli decreased after tonsillectomy, especially with early surgery.<\/jats:p><jats:p><jats:bold>Conclusion:\u2003<\/jats:bold> Tonsillectomy improved clinicopathological features in relatively severe paediatric IgA nephropathy, especially with the early\u2010surgery group. Therapeutic mechanisms may include inhibition of complement activity in glomeruli and glomerular infiltration by activated macrophages.<\/jats:p>","DOI":"10.1111\/j.1440-1797.2012.01620.x","type":"journal-article","created":{"date-parts":[[2012,5,23]],"date-time":"2012-05-23T04:42:19Z","timestamp":1337748139000},"page":"658-664","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Effect and therapeutic mechanisms of tonsillectomy for childhood IgA nephropathy"],"prefix":"10.1111","volume":"17","author":[{"given":"HITOMI","family":"NISHI","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KEISUKE","family":"SUGIMOTO","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SHINSUKE","family":"FUJITA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KOHEI","family":"MIYAZAKI","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"TOMOKI","family":"MIYAZAWA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"NAOKI","family":"SAKATA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MITSURU","family":"OKADA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"TSUKASA","family":"TAKEMURA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,8,26]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra020109"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)90875-3"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2004.00714.x"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2007.10.003"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfm346"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004670000414"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2004.01.005"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2008.509"},{"key":"e_1_2_6_10_2","first-page":"487","article-title":"Japanese guidelines for IgA nephropathy","volume":"44","author":"Tomino Y","year":"2002","journal-title":"Jpn. J. Nephrol."},{"key":"e_1_2_6_11_2","first-page":"178","article-title":"Investigation of the local provocation test to PPP and IgA nephritis","volume":"523","author":"Shiraishi S","year":"1996","journal-title":"Acta Otolaryngol Suppl."},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1797.2008.01083.x"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1797.2011.01442.x"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1042\/CS20040095"},{"key":"e_1_2_6_15_2","first-page":"202","article-title":"Decreased CD4+CD25+ cells and increased dimeric IgA\u2010producing cells in tonsils in IgA nephropathy","volume":"23","author":"Huang H","year":"2010","journal-title":"J. Nephrol."},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V101101"},{"key":"e_1_2_6_17_2","first-page":"8","article-title":"Treatment for IgA nephropathy [Review]","volume":"157","author":"Tomino Y","year":"2007","journal-title":"Contrib. Nephrol."},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10875-010-9451-0"},{"key":"e_1_2_6_19_2","first-page":"208","article-title":"On arthropathy with special reference to sternocostoclavicular hyperostosis","volume":"47","author":"Shido F","year":"1992","journal-title":"Adv. Otorhinolaryngol"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.08630910"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2003.00935.x"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfq674"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1159\/000100431"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-006-0272-6"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1620\/tjem.218.11"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00844284"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1440-1797.2012.01620.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1440-1797.2012.01620.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,14]],"date-time":"2023-10-14T04:02:05Z","timestamp":1697256125000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1440-1797.2012.01620.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,8,26]]},"references-count":25,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2012,9]]}},"alternative-id":["10.1111\/j.1440-1797.2012.01620.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1440-1797.2012.01620.x","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,8,26]]},"assertion":[{"value":"2012-08-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}