Clinical, histopathological and immunofluorescent findings of IgA nephropathy

Abstract

Background: IgA nephropathy, a prevalent disease in Asia, is considered the main cause of end stage renal disease among primary glomerular disease.

Objective: To determine the frequency of different clinical, histopathological and immunofluorescent characteristics of IgA nephropathy.

Methods: Renal biopsies of 376 patients were received for immunofluorescent and for histopathological studies. Biopsies were stained with fluorescene isothyocyanate (FITC) labeled antibodies against IgG, IgA, IgM, C3, C4 and fibrinogen for fluorescent microscopy. For histopathological examination, the specimens were stained with hematoxylin and eosin, periodic acid schiff and methanamine silver stains for light microscopy.

Results: IgA nephropathy was diagnosed in 39 cases (10.4%) with a mean age 31.5 years and a male to female ratio of 2.8:1. The disease was observed in 11(29.7%) patients aged 21-30 years, followed by 8 patients (21.6%) aged 11-20 years group. Nephrotic range proteinuria was the most common laboratory finding which was detected in 11 patients (37%). Mesangioproliferative glomerulonephritis was the most common histopathological finding which was found in 7 patients (35%). IgA with other immunoglobulins and complements were deposited in 28 specimens (71.8%) as detected by immunofluorescence.

Conclusion: IgA nephropathy is common in young people and one third of it results in end stage renal disease. We suggest that Immunofluorescent assay can be considered for the conclusive diagnosis of IgA nephropathy in young patients presenting with proteinuria/hematuria.