Discrimination between postinfectious IgA-dominant glomerulonephritis and idiopathic IgA nephropathy.
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.
Wen
Yao-Ko
YK
Division of Nephrology, Changhua Christian Medical Center, Changhua, Taiwan, Republic of China. wensnake1100@yahoo.com.tw
Chen
Mei-Ling
ML
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000150:complications* / Q000276:immunology; D003937:Diagnosis, Differential; D005260:Female; D005922:Glomerulonephritis, IGA / Q000382:microbiology / Q000473:pathology*; D006801:Humans; D007678:Kidney Glomerulus / Q000648:ultrastructure*; D008297:Male; D008875:Middle Aged; D055815:Young Adult