IgA Nephropathy

IgA nephropathy, also known as Berger's disease, is the commonest glomerulonephritis.

The classical patient is a young man with haematuria after an upper respiratory tract infection.

Overall micro or macrohaematuria is the presenting feature in around 40% of cases.

Histologically there is mesangial hyperplasia and on immunofluorescence there is IgA and C3 deposition.

It is often a subclinical condition, but amongst those for whom it becomes clinically apparent there is around 20% progression to end stage renal failure at 20 years.

A poorer prognosis is associated with
  • male gender (the majority of sufferers are male)
  • proteinuria
  • obesity 

Associated conditions include

Management
  • Angiotensin 2 inhibitor or ACE-i
  • if this fails, ?immunosupression
  • in renal failure consider transplant, although IgA nephropathy recurs in the majority of grafts

Henoch Schonlein Purpura is sometimes regarded as the systemic manifestation of IgA nephropathy.


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