Nepritic syndrome - IgA nephropathy

Question 1

What is IgA nephropathy?

Answer 1

The deposition of polymeric underglycosylated IgA in the mesangial matrix. (most common nephropathy worldwide)

Question 2

What disease is considered a characteristic form of IgA nephropathy?

Answer 2

Henoch-Schonlein purpura

Question 3

What disease also shows and increase in incidence of IgA nephropathy?

Answer 3

Celiac disease and chronic liver disease who have decreased hepatobiliary clearance.

Question 4

What diseases can IgA nephropathy be secondary to?

Answer 4

1. inflammatory bowel disease
2. psoriasis
3. dermatitis herpetiformis
4. ankylosing spondylitis

Question 5

In what subset of patients is IgA nephropathy most common?

Answer 5

Children and young males

Question 6

In what race is IgA nephropathy most prevalent?

Answer 6

East Asians

May have genetic predisposition or be familial

Question 7

What infections usually trigger IgA nephropathy?

Answer 7

Upper respiratory or gastrointestinal tract infection (mucosal infection).

Question 8

How soon after infection does nephritic urinary sediment occur?

Answer 8

1 or 2 days after infection

Question 9

What are the findings in IgA on immunoflurescence?

Answer 9

Mesangial IgA deposits with C3 and properdin

Question 10

What is the treatment for IgA nephropathy?

Answer 10

1. Steroids
2. ACE inhibitors
3. ARB

Question 11

What are the risk factors for progression to renal failure with IgA nephropathy?

Answer 11

1. Heavy proteiuria
2. Decreased GFR
3. Older age at onset
4. Familial forms of the disease
5. Uncrontrolled hypertension
6. Microscopic features such as crescentic pattern disease, diffuse mesangial proliferation etc