Discrimination between postinfectious IgA-dominant glomerulonephritis and idiopathic IgA nephropathy.

Abstract

BACKGROUND:

A unique form of postinfectious glomerulonephritis (PIGN) with IgA-dominant deposition mimicking IgA nephropathy has been increasingly reported.

METHODS:

We compared the clinical and histological features of 12 patients with postinfectious IgA-dominant glomerulonephritis to 134 patients with idiopathic IgA nephropathy.

RESULTS:

In addition to hypocomplementemia and subepithelial hump-shaped deposits characteristic of PIGN, patients with postinfectious IgA-dominant glomerulonephritis had older age (62.3 +/- 16.9 vs. 37.9 +/- 16.3 years; p < 0.001) and more frequently presented with acute renal failure (83.3% vs. 10.4%; p < 0.001) than patients with idiopathic IgA nephropathy. Moreover, glomerular changes including endocapillary proliferation, neutrophil infiltration, and capillary loops deposits by immunofluorescence were more commonly present in postinfectious IgA-dominant glomerulonephritis group (p < 0.001).

CONCLUSIONS:

PIGN could be characterized by glomerular IgA-dominant deposition resembling idiopathic IgA nephropathy. It is essential to differentiate postinfectious IgA-dominant glomerulonephritis from idiopathic IgA nephropathy because of the different treatments and prognosis of the two diseases.

• Authors: Yao-Ko Wen, Mei-Ling Chen
• Journal: Renal failure (Ren Fail) Vol. 32 Issue 5 Pg. 572-7 (Jun 2010) ISSN: 1525-6049 [Electronic] England
• PMID: 20486840 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Bacterial Infections (complications, immunology)
• Diagnosis, Differential
• Female
• Glomerulonephritis, IGA (microbiology, pathology)
• Humans
• Kidney Glomerulus (ultrastructure)
• Male
• Middle Aged
• Young Adult