[Demonstration of mesangial IgA deposits in kidney biopsies of pediatric patients: comparison with the clinical picture].
Clinical and morphological findings were evaluated in 25 children with mesangial IgA deposits. 19 patients had recurrent macroscopic hematuria (n = 10), chronic proteinuria > 40 mg/(m2.h) (n = 5), recurrent hematuria with chronic proteinuria (n = 3), or chronic nephrotic syndrome (n = 1). The glomerular involvement was similar in six patients with history of Schönlein-Henoch purpura and in 13 patients without such history: normal or nearly normal glomeruli (n = 3), focal and segmental glomerulonephritis (n = 11) and diffuse proliferative glomerulonephritis (n = 5). End-stage renal disease developed in two patients with proteinuria > 40 mg/(m2.h) and more than 50% of their glomeruli are affected by crescents. The common histopathological features in patients with and without history of Schönlein-Henoch purpura suggest a common pathogenesis. The risk of poor outcome appears, related to the severity of proteinuria and to the presence of crescents, in more than 50% of glomeruli. Mesangial IgA deposits were also demonstrated in six children with steroid-responsive idiopathic nephrotic syndrome: light microscopic studies revealed normal or nearly normal glomeruli in five and focal segmental glomerular sclerosis in one patient. The microscopic findings were clearly different in the six patients with idiopathic nephrotic syndrome as compared with the patient with chronic nephrotic syndrome, who presented with severe glomerular lesions and extensive crescent formation. The results indicate that the presence of mesangial IgA deposits in the clinical setting of idiopathic childhood nephrotic syndrome is incidental and that such patients should still be considered as having idiopathic nephrotic syndrome in spite of their immunopathological features.
D000293:Adolescent; D001707:Biopsy, Needle; D002648:Child; D002675:Child, Preschool; D005260:Female; D005922:Glomerulonephritis, IGA / Q000150:complications / Q000276:immunology* / Q000628:therapy; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications; D007070:Immunoglobulin A / Q000302:isolation & purification*; D007678:Kidney Glomerulus / Q000276:immunology* / Q000473:pathology*; D008297:Male; D009404:Nephrotic Syndrome / Q000276:immunology; D011507:Proteinuria / Q000473:pathology; D016896:Treatment Outcome
D007070:Immunoglobulin A
Nachweis von mesangialen IgA-Ablagerungen in der Nierenbiopsie pädiatrischer Patienten: Vergleich mit dem klinischen Bild.