title: IgA-associated glomerulonephritis with membranoproliferative glomerulonephritis-like pattern in two children.
abstract: In this article, we report two patients with IgA-associated glomerulonephritis with a membranoproliferative glomerulonephritis (MPGN) -like pattern. Both patients had nephrotic syndrome at onset. One patient was treated with high-dose alternate-day prednisolone (PSL), and the other with indomethacin and low-dose PSL. One lost the urinary abnormalities 3 years after starting treatment. The other lost the nephrotic state and hematuria over a 5-year period, but proteinuria persisted until the last follow-up. Both patients had diffuse proliferative changes with mesangial interposition and subendothelial deposits, associated with strongly positive deposits of C3 and IgA along the capillary walls of the glomeruli. These two patients showed histological changes compatible with type-I MPGN, but the pattern of IgA deposits was not typical of idiopathic MPGN or IgA nephropathy. We assume this is a rare form of MPGN, not associated with liver disease or other systemic diseases.
authors.affiliation: Department of Pediatrics, Yamato City Hospital, 8-3-6 Fukaminishi, Yamato, Kanagawa 242-8602, Japan. kikuo.iitaka@gov.city.yamato.kanagawa.jp
authors.forename: Kikuo
authors.initials: K
authors.lastname: Iitaka
authors.forename: Asako
authors.initials: A
authors.lastname: Yamamoto
authors.forename: Natsuko
authors.initials: N
authors.lastname: Ogawa
authors.forename: Toru
authors.initials: T
authors.lastname: Sekine
authors.forename: Shinya
authors.initials: S
authors.lastname: Tamai
authors.forename: Osamu
authors.initials: O
authors.lastname: Motoyama
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001706:Biopsy; D002455:Cell Division / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005920:Glomerular Mesangium / Q000473:pathology; D005922:Glomerulonephritis, IGA / Q000188:drug therapy / Q000473:pathology*; D015432:Glomerulonephritis, Membranoproliferative / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D007668:Kidney / Q000473:pathology; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008854:Microscopy, Electron; D008856:Microscopy, Fluorescence
chemical_list: D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone; D007213:Indomethacin