IgA nephropathy Flashcards Preview

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Flashcards in IgA nephropathy Deck (6)
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1
Q

What is IgA nephropathy?

A
  • also called Berger’s disease or mesangioproliferative glomerulonephritis
  • commonest cause of glomerulonephritis worldwide
  • thought to be caused by mesangial deposition of IgA immune complexes, often post-infection
  • there is considerable pathological overlap with Henoch-Schonlein purpura (HSP)
  • histology: mesangial hypercellularity, positive immunofluorescence for IgA & C3
2
Q

How do you differentiate between IgA nephropathy and post-streptococcal glomerulonephritis?

A
  • post-streptococcal glomerulonephritis is associated with low complement levels
  • main symptom in post-streptococcal glomerulonephritis is proteinuria (although haematuria can occur)
  • there is typically an interval between URTI and the onset of renal problems in post-streptococcal glomerulonephritis
3
Q

How does IgA nephropathy commonly present?

A
  • young male, recurrent episodes of macroscopic haematuria
  • typically associated with mucosal infections e.g., URTI
  • nephrotic range proteinuria is rare
  • renal failure
  • recovery often rapid between attacks
4
Q

What conditions are associated with IgA nephropathy?

A
  • alcoholic cirrhosis
  • coeliac disease/dermatitis herpetiformis
  • Henoch-Schonlein purpura
5
Q

What is the management of IgA nephropathy?

A
  • BP control with ACE inhibitor

- With a nephritic presentation, immunosuppression may slow decline of renal function

6
Q

What is the prognosis in IgA nephropathy?

A
  • 20% of adults develop ESRF over 20yrs.
  • markers of good prognosis: frank haematuria
  • markers of poor prognosis: male gender, proteinuria (especially > 2 g/day), hypertension, smoking, hyperlipidaemia, ACE genotype DD