[Clinical characteristics of children with an initial onset of IgA nephropathy with nephrotic syndrome].
OBJECTIVE
To study the clinical characteristics of children with an initial onset of IgA nephropathy with nephrotic syndrome and compare them with children with primary nephrotic syndrome, in order to provide a theoretical basis for the differential diagnosis of the two diseases.


METHODS
Fifty children diagnosed with an initial onset of IgA nephropathy with nephrotic syndrome were included in this study. Seventy-two children diagnosed with an initial onset of primary nephrotic syndrome served as the control group. The clinical and laboratory examination characteristics were compared between the two groups.


RESULTS
The IgA nephropathy group had significantly higher incidence rates of gross haematuria, microscopic haematuria, hypertension, acute kidney injury, low serum high-density lipoprotein cholesterol, anemia, low serum complement C4, steroid resistance, and nephritis-type nephrotic syndrome and a significantly lower incidence of elevated serum IgE compared with the control group (P<0.05). There were significant differences in serum creatinine, serum uric acid, serum total cholesterol, serum high-density lipoprotein cholesterol, serum IgE, serum complement C4, and hemoglobin levels between the IgA nephropathy and the control groups (P<0.05). The thresholds of serum IgE (<131.2 IU/mL) and high-density lipoprotein cholesterol (<1.35 mmol/L) were reference parameters in the differential diagnosis of IgA nephropathy with nephrotic syndrome and primary nephrotic syndrome.


CONCLUSIONS
Children with IgA nephropathy presenting nephrotic syndrome manifest mainly as nephritis type and steroid-resistant type in the clinical classification. Cinical manifestations accompanied by serum levels of high-density lipoprotein cholesterol and IgE are helpful for differential diagnosis of IgA nephropathy presenting nephrotic syndrome and primary nephrotic syndrome.
Department of Nephrology, Kidney Laboratory of Hunan Pediatric Research Institute, Hunan Children's Hospital, Changsha 410007, China. Lizh0731@aliyun.com.
Liang
L
Zhang
Zhi-Hui
ZH
Li
Yan
Y
Yin
Cui-Rong
CR
Duan
Mai
M
Xun
Tian-Hui
TH
Wu
Yi
Y
Zhang
Yun-Feng
YF
Ding
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D008076:Cholesterol, HDL / Q000097:blood; D003181:Complement C4 / Q000032:analysis; D005260:Female; D005922:Glomerulonephritis, IGA / Q000097:blood / Q000150:complications*; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D009404:Nephrotic Syndrome / Q000097:blood / Q000150:complications*
D008076:Cholesterol, HDL; D003181:Complement C4; D007073:Immunoglobulin E