scholarly journals Immunoglobulin A nephropathy: Basic characteristics

2003 ◽  
Vol 56 (5-6) ◽  
pp. 281-285
Author(s):  
Lada Petrovic ◽  
Slobodan Curic ◽  
Igor Mitic ◽  
Dusan Bozic ◽  
Slavenka Vodopivec ◽  
...  
Keyword(s):  
Light Microscopy ◽  
Renal Biopsy ◽  
Clinical Features ◽  
Serological Test ◽  
Immunoglobulin A ◽  
Vascular Lesions ◽  
Immunoglobulin A Nephropathy ◽  
Macroscopic Hematuria ◽  
Female Ratio ◽  
Pathologic Features

Introduction Immunoglobulin A nephropathy (IgAN) is one of the most common forms of primary glomerulonephritis in many countries. Most clinical features of IgAN point to a renal problem, such as recurrent macroscopic hematuria or asymptomatic microscopic hematuria and proteinuria. Pathologic features of IgAN present with different types and different degrees of glomerular tubulointerstitial and vascular lesions. The aim of this study was detailed analysis of clinical and laboratory findings, as well as findings of immunofluorescence and light microscopy. We also investigated associations between these factors. Material and methods We investigated 60 patients who underwent renal biopsy. The study was partly retrospective and partly prospective. Results The average age of patients was 34.19 years. Male female ratio was 2.33:1. IgAN was most frequently asymptomatic (83.33%) as microhematuria and proteinuria, while gross hematuria was found in 16.667%. Renal biopsy material was analyzed by light microscopy revealing changes in all glomerular structures. Immunofluorescence microscopy demonstrated dominant IgA deposits. This study established association of glomerulosclerosis with clinical features of disease. Discussion and conclusions IgAN frequently develops in the 4th decade of life, mostly in males and presents as asymptomatic (83.33%). Patohistological changes include all glomerular structures. There is no specific serological test for IgAN, but pathological changes affect clinical features of the disease, as proteinuria and increase of creatinine concentration.

scholarly journals P0488IG A NEPHROPATHY: ANALYSIS OF 501 BIOPSY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Marwa Omrane ◽  
Raja Aoudia ◽  
Mondher Ounissi ◽  
Soumaya Chargui ◽  
Mouna Jerbi ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Vascular Lesions ◽  
Macroscopic Hematuria ◽  
Systematic Screening ◽  
Female Ratio ◽  
Male Predominance ◽  
Glomerular Lesions ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims Mesangial deposits Ig A was described the first time in 1968 by Berger and Hinglais. It remains the most common primary glomerulonephritis worldwide. It is often idiopathic but can also be secondary. The aim of our study is to describe the epidemiologic characteristics, the incidence and the anatomopathological features of 501 IgA nephropathy (IgA N) patients. Method It is a retrospective mono-centric study including patients having IgA N in the renal biopsy done in our department among a period of 17 years. Results We analyzed data of 8427 patients who underwent renal biopsy. 81% had glomerular nephropathy with 7.3% (501) IgA N. A male-to-female ratio of 2.27. The average age was 28.7 years. IgA N was primary in 80.2% cases and secondary in 17.8% cases. The most frequent secondary IgA N was rheumatoid purpura (74.8%). There was a male predominance in Berger‘s disease as well as in rheumatoid purpura. Berger’s disease was more common in adults, whereas rheumatoid purpura was more common in children. The main indication of renal biopsy was proteinuria with hematuria in 23.2% of cases and nephrotic syndrome in 23.8%. The association of non-nephrotic proteinuria, hematuria, arterial hypertension and renal injury was found in 9.3% whereas isolated macroscopic hematuria only in 6.4% of cases. According to HAAS classification, HAAS 3 was the most frequent. OXFORD classification used only from 2010, and M1, S1, E0, T0 and M1, S1, E0, T2 were the most frequent. Glomerular lesions were associated to tubulo interstitial and vascular lesions in 48.2% of cases. Conclusion IgA nephropathy is the most common glomerular disease and a frequent cause of end stage renal disease. Because of a clear increase of it’s incidence in our country and the delay in the diagnosis, a systematic screening of urines is needed in our country as it’s done in Singapore and Japan.

scholarly journals Immunoglobulin A nephropathy and its prognostic factors

2002 ◽  
Vol 55 (11-12) ◽  
pp. 517-522
Author(s):  
Lada Petrovic ◽  
Slobodan Curic ◽  
Igor Mitic ◽  
Dusan Bozic ◽  
Slavenka Vodopivec ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Renal Biopsy ◽  
Clinical Features ◽  
Normal Renal Function ◽  
Immunoglobulin A ◽  
Immunoglobulin A Nephropathy ◽  
Laboratory Findings ◽  
Heavy Proteinuria ◽  
The Moment

Introduction Immunoglobulin A nephropathy (IgAN) is a clinicopathological entity characterized by diffuse glomerular mesangial deposition of IgA as the predominant immunoglobulin. Renal biopsy reveals a spectrum of changes in glomerula, tubulointerstitium and blood vessels. 20-50% of all patients develop end-stage renal failure 20 years after onset of disease. The aim of this study was to investigate the incidence of IgAN and to analyze clinicopathological changes and prognosis of IgAN. Material and methods The study included 60 patients with biopsy-proved IgAN without some other systemic diseases or Henoch-Schonlen purpura. We analyzed clinical features of the disease, laboratory findings, findings of immunofluorescence and light microscopy and prognosis of IgAN. The study is partly retrospective and partly prospective. Results and discussion Incidence of the disease in the period 1981-1997 was 9.78%. At the moment of renal biopsy 63.16% of patients had normal renal function, 31.58% had stage I and 5.25% had stage II chronic renal failure. At the end of study 21.05% of investigated patients were included into the worse stage of renal failure in regard to the initial stage. Progression of renal damage correlated with special tubulointerstitial damage and heavy proteinuria. Conclusions In this study we found severe histopathological changes in the group with already impaired renal function and these changes correlated with laboratory findings, clinical features and prognosis. Normal renal function at the moment of renal biopsy pointed to risk for further damage. Changes in the tubulointerstitium and mesangium, heavy proteinuria and hypertension affect the disease prognosis. Evolution to the higher stage of renal failure was 1.24% per year and this requires long-term follow-up of patients with IgAN.

scholarly journals Indian scenario of IgA nephropathy: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
pp. 159-65
Author(s):  
Anju Khairwa
Keyword(s):  
Systematic Review ◽  
Iga Nephropathy ◽  
Clinical Features ◽  
Meta Analysis ◽  
Microscopic Hematuria ◽  
Macroscopic Hematuria ◽  
Female Ratio ◽  
Cochrane Database ◽  
Male Female Ratio ◽  
Indian Scenario

Background: IgA nephropathy (IgAN) is most common primary glomerulopathy. There are variations in prevalence of IgAN and its clinical features in different studies from India. Aim: To summarize overall scenario of IgAN in India. Methods: In this systematic review, studies related to IgAN and related renal disease were included. Data searched were PubMed, EMBASE, Google scholar, and Cochrane Database from inception to 31st January 2019. Results: Total 49 studies (N=2480) were included: 21studies (N=2309) of primary IgAN; 19 studies (N=21) of Secondary IgAN; four studies (N=133) of IgA vasculitis nephropathy (IgAVN); and five studies (N=17) of IgA dominant nephropathy (IgADN). Prevalence of IgAN was 16.5% in India. Age of affected persons was ranging from 27.2±16.7 to 48.6±21.3 years . Male female ratio was 1.8:1. Clinical features of Primary IgAN, IgAVN, IgADN & Secondary IgAN were microscopic hematuria (49.6%, 44.4%, 15.6% & 59.5%), macroscopic hematuria (5.1%, 0.4%,40.9%,& 35.7%), Subnephrotic proteinuria (42.1%, 29.4%, 23.2%, & 52.3%), nephrotic proteinuria (16.0%, 4.4%, 76.8%,& 47.6%), and hypertension (25.8%,18.3%, 35.5%,& 47.6%).. The 24 hours proteinuria was ranging from 2.6±1.5 to 4.7±2.3 gm/day and serum creatinine (mg/dl) was ranging from 0.9±0 to 3.5±3.9 mg/dl. Histolomorphologically, all type of IgAN showed mesangial hypercellularity and Immunofluorescence revealed IgA deposition. Conclusion: The overall prevalence of primary IgAN in India was 16.5%. The subnephrotic proteinuria and microscopic hematuria were common clinical features. Keywords: IgA Nephropathy; histomorphology; prevalence; India.

scholarly journals Renal Outcomes in Brazilian Patients with Immunoglobulin A Nephropathy and Cellular Crescentic Lesions

2020 ◽  
Vol 45 (3) ◽  
pp. 431-441
Author(s):  
Precil Diego Miranda de Menezes Neves ◽  
Rafaela Bezerra Brito Pinheiro ◽  
Cristiane Bitencourt Dias ◽  
Luis Yu ◽  
Leonardo de Abreu Testagrossa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Biopsy ◽  
Biopsy Specimen ◽  
Immunoglobulin A ◽  
Composite Outcome ◽  
Immunoglobulin A Nephropathy ◽  
Oxford Classification ◽  
Cox Regression Analysis ◽  
Independent Risk Factors ◽  
The Impact

Background and Aim: Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulopathy. The Oxford classification was recently updated to include crescents as markers of poor prognosis. The aim of this study was to evaluate the impact of cellular crescents on the prognosis of patients with IgAN in Brazil. Methods: This was a single-centre retrospective analysis of medical records and renal biopsies in patients with IgAN. The renal biopsy findings were classified according to the revised Oxford classification: mesangial hypercellularity, endocapillary hypercellularity (E), segmental glomerulosclerosis (S), tubular atrophy or interstitial fibrosis (T), and crescent formation (C). We evaluated a composite outcome (progression to end-stage renal disease or creatinine doubling). We performed analyses between the patients with crescents in the renal biopsy specimen (C1/C2 group) and those without such crescents (C0 group). Results: We evaluated 111 patients, of whom 72 (65.0%) were women, 80 (72.0%) self-identified as White, 73 (65.6%) were hypertensive, and 95 (85.6%) had haematuria. The distribution of patients according to cellular crescentic lesions was: C0, 80 (72%); C1, 27 (24.4%); C2, 4 (3.6%). The composite outcome was observed in 33 (29.72%) of the 111 patients. In comparison with the C0 group, the C1/C2 group had higher proportions of patients with hypertension (p = 0.04), haematuria (p = 0.03), worse serum creatinine (p = 0.0007), and worse estimated glomerular filtration rate (p = 0.0007). The C1/C2 group also had higher proportions of patients in whom the biopsy specimen was classified as E1 (p = 0.009), S1 (p = 0.001), or T1/T2 (p = 0.03), In addition, the mean follow-up period was shorter in the C1/C2 group (p < 0.0001). Furthermore, the composite outcome was observed in a greater proportion of patients and in a shorter length of time in the C1/C2 group than in the C0 group (p = 0.002 and p = 0.0014, respectively). In a Cox regression analysis, the independent risk factors for the composite outcome had Oxford classifications of S1, T1/T2, and C1/C2. Conclusion: Oxford classification findings of S1, T1/T2, or C1/C2 were independent risk factors for the composite outcome, corroborating previous studies.

Immunoglobulin A nephropathy and Henoch–Schönlein purpura

2010 ◽  
pp. 3971-3977
Author(s):  
Jonathan Barratt ◽  
John Feehally
Keyword(s):  
Renal Biopsy ◽  
Immunoglobulin A ◽  
Hinge Region ◽  
Proliferative Glomerulonephritis ◽  
Mesangial Proliferative Glomerulonephritis ◽  
Immunoglobulin A Nephropathy ◽  
Glomerular Mesangium ◽  
The World ◽  
Schonlein Purpura ◽  
Henoch Schönlein Purpura

Immunoglobulin A nephropathy (IgAN) is the commonest pattern of glomerulonephritis identified in areas of the world where renal biopsy is widely practised. It is defined pathologically by IgA deposition in the glomerular mesangium accompanied by a mesangial proliferative glomerulonephritis which may vary greatly in severity. Aetiology is uncertain, but abnormalities of IgA1 hinge-region ...

scholarly journals Clinical Features, Treatment and Prognostic Factors of Post-Transplant Immunoglobulin A Nephropathy

2018 ◽  
Vol 23 ◽  
pp. 166-175 ◽  
Author(s):  
Diogo Buarque Cordeiro Cabral ◽  
Tainá Veras de Sandes-Freitas ◽  
José Osmar Medina-Pestana ◽  
Gianna Mastroianni-Kirsztajn
Keyword(s):  
Prognostic Factors ◽  
Clinical Features ◽  
Immunoglobulin A ◽  
Immunoglobulin A Nephropathy ◽  
Post Transplant

scholarly journals Renal hemosiderosis presenting with acute kidney Injury and macroscopic hematuria in Immunoglobulin A nephropathy: a case report

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shinya Taguchi ◽  
Sumi Hidaka ◽  
Mitsuru Yanai ◽  
Kunihiro Ishioka ◽  
Kenji Matsui ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Biopsy ◽  
Prussian Blue ◽  
Iga Nephropathy ◽  
Acute Tubular Necrosis ◽  
Immunoglobulin A ◽  
Kidney Injury ◽  
Upper Respiratory Tract ◽  
Macroscopic Hematuria ◽  
Tubular Necrosis

Abstract Background Macroscopic hematuria-associated acute kidney injury (AKI) is a well-known complication of immunoglobulin A (IgA) nephropathy. In such cases, intratubular obstruction by red blood cell (RBC) casts and acute tubular necrosis are mainly observed pathologically. Herein, we report the case of a patient with IgA nephropathy presenting with AKI following an episode of macrohematuria. The patient presented with severe renal tubular hemosiderosis and acute tubular necrosis and without any obvious obstructive RBC casts. Case presentation A 68-year-old woman, who was diagnosed with IgA nephropathy on renal biopsy 6 years ago, was admitted to our hospital after an episode of macroscopic glomerular hematuria and AKI following upper respiratory tract infection. Renal biopsy showed mesangial proliferation of the glomeruli, including crescent formation in 17 % of the glomeruli, and acute tubular necrosis without obvious hemorrhage or obstructive RBC casts. The application of Perls’ Prussian blue stain showed hemosiderin deposition in the renal proximal tubular cells. Immunofluorescence showed granular mesangial deposits of IgA and C3. Based on these findings, she was diagnosed with acute tubular necrosis with a concurrent IgA nephropathy flare-up. Moreover, direct tubular injury by heme and iron was considered to be the cause of AKI. She was treated with intravenous pulse methylprednisolone followed by oral prednisolone. Thereafter, the gross hematuria gradually faded, and her serum creatinine levels decreased. Conclusions IgA nephropathy presenting with acute kidney injury accompanied by macrohematuria may cause renal hemosiderosis and acute tubular necrosis without obstructive RBC casts. Hemosiderosis may be a useful indicator for determining the pathophysiology of macroscopic hematuria-associated AKI. However, renal hemosiderosis may remain undiagnosed. Thus, Perls’ Prussian blue iron staining should be more widely used in patients presenting with hematuria.

scholarly journals Prediction of diagnosis of immunoglobulin a nephropathy prior to renal biopsy and correlation with urinary sediment findings and prognostic grading

2008 ◽  
Vol 22 (2) ◽  
pp. 114-118 ◽  
Author(s):  
Kazutaka Nakayama ◽  
Isao Ohsawa ◽  
Atsuko Maeda‐Ohtani ◽  
Maki Murakoshi ◽  
Satoshi Horikoshi ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Immunoglobulin A ◽  
Immunoglobulin A Nephropathy ◽  
Urinary Sediment
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