title: A novel case report of sickle cell disease-associated immunoglobulin A nephropathy: the diagnostic value of erythrocyte dysmorphism evaluation.
abstract: Sickle cell disease is a severe disease with a genetic pattern; it may cause anemia, vaso-occlusive phenomena, and multiorgan injury. It may damage any renal compartment, thereby causing tubular abnormalities, papillary necrosis, or glomerulopathies such as focal and segmental glomerulosclerosis and membranoproliferative pattern. The clinical consequences are hematuria and proteinuria. Hematuria associated with SCD is characteristically isomorphic (non-glomerular). This case report describes a novel case of a patient with sickle cell disease who presented with proteinuria and microscopic dysmorphic (glomerular) hematuria. A renal biopsy revealed immunoglobulin A nephropathy. Despite the fact that immunoglobulin A nephropathy is the most commonly diagnosed glomerulonephritis worldwide, an association between this entity and sickle cell disease has not yet been reported, probably because all cases of hematuria in patients with sickle cell disease have been regarded as secondary to sickle cell disease. Thus, new approaches are necessary to differentiate these conditions, such as evaluation of urinary erythrocyte dysmorphism, even more so because these two entities have different therapeutic options, morbidity, and mortality rates.
authors.affiliation: Department of Pathology, Ribeirão Preto Medical School, University of São Paulo Brazil.
authors.forename: Gyl Eb
authors.initials: GE
authors.lastname: Silva
authors.affiliation: Department of Pathology, Ribeirão Preto Medical School, University of São Paulo Brazil.
authors.forename: André C
authors.initials: AC
authors.lastname: Teixeira
authors.affiliation: Division of Nephrology, Ribeirão Preto Medical School, University of São Paulo Brazil.
authors.forename: José Gg
authors.initials: JG
authors.lastname: Vergna
authors.affiliation: Division of Nephrology, University Hospital of Federal University of Maranhão Brazil.
authors.forename: Natalino
authors.initials: N
authors.lastname: Salgado-Filho
authors.affiliation: Department of Pathology, Ribeirão Preto Medical School, University of São Paulo Brazil.
authors.forename: Leandro Z
authors.initials: LZ
authors.lastname: Crivellentti
authors.affiliation: Department of Pathology, Ribeirão Preto Medical School, University of São Paulo Brazil.
authors.forename: Roberto S
authors.initials: RS
authors.lastname: Costa
authors.affiliation: Division of Nephrology, Ribeirão Preto Medical School, University of São Paulo Brazil.
authors.forename: Márcio
authors.initials: M
authors.lastname: Dantas
keywords: IgA nephropathy; erythrocyte dymorphism; glomerulonephritis; sickle cell disease