IgA Vasculitis Nephritis

Question 1

Classic tetrad of IgA Vasculitis Nephritis

Answer 1

1. Palpable purpura
2. Abdominal pain
3. Arthritis/arthralgia
4. Evidence for kidney disease

Question 2

Urinalysis and BP monitoring in IgA vasculitis nephritis

Answer 2

Every week for the first 4 weeks since onset then every month for the next 6 months

Question 3

Indications for pedia nephro consult in IgA Vasculitis Nephritis

Answer 3

1. Proteinuria
2. Kidney insufficiency
3. Hypertension along with hematuria

Question 4

Indications for Kidney biopsy in IgA vaaculitis nephritis

Answer 4

1. Significant proteinuria (urine protein >1g/day or UPCR >1)
2. Significant hypertension
3. Elevated serum creatinine

Question 5

Treatment of those with severe clinical kidney involvement (nephrotic range proteinura, elevated serum creatinine, hypertension

Answer 5

Oral prednisone (1mkD for 3 months) and
ACE inhibitors;
Followed bu Azathioprone or mycophenolate mofetil if severe clinical involvement persists

Question 6

Treatment of those with severe histologic manifestations (>50% glomerular crescents)

Answer 6

IV methylprednisolone pulses for 3 days followed by a combination of oral prednisone (for 3 months) and azathioprone or mycophenolate mofetil (extended course)

Question 7

Treatment of those with most severe histology (>75% glomerular crescents) and progressive kidney disease

Answer 7

IV steroids plus plasmapharesis