Abstract | BACKGROUND AND OBJECTIVES: DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: RESULTS: The cohort consisted of 17 patients, including 10 men and 15 adults. The median serum creatinine was 0.9 mg/dl (range=0.7-3.1), median 24-hour urine protein was 8.0 g/d (3.0-18.0 g), and 14 patients were fully nephrotic, whereas the remaining 3 patients fulfilled two of three criteria for nephrotic syndrome. Biopsies revealed IgA-dominant or codominant deposits accompanied by mesangial proliferation in 14 patients (82.4%). Electron microscopy showed mesangial deposits and extensive foot process effacement (median=90%). Initial treatment consisted of corticosteroids, although many patients required additional agents to maintain remission status. Over a median follow-up of 20 months (2.2-82 months), 14 patients experienced a complete response, and 3 patients showed a partial response, with a median response time of 2 months (0.5-27 months). At least one relapse of nephrotic syndrome occurred in nine patients (53%). All patients exhibited stable or improved renal function over the follow-up period. CONCLUSIONS: The findings in this cohort and previous studies suggest that rare cases of mild IgA nephropathy with nephrotic range proteinuria exhibit a clinical presentation, biopsy findings, treatment response, and outcome more typical of IgA nephropathy with superimposed minimal change disease. This study favors the view that such cases represent a dual glomerulopathy.
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Authors | Leal C Herlitz, Andrew S Bomback, Michael B Stokes, Jai Radhakrishnan, Vivette D D'Agati, Glen S Markowitz |
Journal | Clinical journal of the American Society of Nephrology : CJASN
(Clin J Am Soc Nephrol)
Vol. 9
Issue 6
Pg. 1033-9
(Jun 06 2014)
ISSN: 1555-905X [Electronic] United States |
PMID | 24721885
(Publication Type: Journal Article)
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Copyright | Copyright © 2014 by the American Society of Nephrology. |
Chemical References |
- Adrenal Cortex Hormones
- Immunosuppressive Agents
- Serum Albumin
- Creatinine
|
Topics |
- Adrenal Cortex Hormones
(therapeutic use)
- Adult
- Aged
- Child
- Child, Preschool
- Creatinine
(blood)
- Female
- Follow-Up Studies
- Glomerulonephritis, IGA
(blood, complications, drug therapy, pathology)
- Humans
- Immunosuppressive Agents
(therapeutic use)
- Male
- Middle Aged
- Nephrosis, Lipoid
(blood, complications, drug therapy, pathology)
- Proteinuria
(etiology)
- Recurrence
- Retrospective Studies
- Serum Albumin
(metabolism)
- Treatment Outcome
- Young Adult
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