IgA Deposits and Acute Glomerulonephritis in a Patient With Staphylococcal Infection

Long, Joshua; Cook, William J.

doi:10.1053/j.ajkd.2006.06.015

Cited by 22 publications

(16 citation statements)

References 11 publications

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“…IgA dominant PIGN is a relatively recently recognized entity, and it is important to distinguish it from IgA nephropathy, with which it can easily be confused [9,12,13,14,15,16,17,18,19]. The most frequent histological pattern of glomerular injury in IgA-dominant PIGN is endocapillary and exudative glomerulonephritis, identical to that seen in poststreptococcal glomerulonephritis; however, pure mesangial proliferative glomerulonephritis was described in 33% of reported patients with this disease [6].…”

Section: Discussionmentioning

confidence: 99%

An unusual case of IgA-dominant postinfectious glomerulonephritis: a case report and review of the literature

Wągrowska-Danilewicz

Danilewicz²,

Fisiak³

et al. 2016

pjp

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We report a case of IgA-dominant postinfectious glomerulonephritis in a 49-yearold man presenting with acute kidney injury, nephrotic range proteinuria and hematuria. He suffered from ischemic heart disease, cardiac insufficiency, mitral regurgitation, tricuspid insufficiency, septal aneurysm and hypertension. Renal biopsy revealed segmental and focal endocapillary and mesangial hypercellularity, and thickening of the glomerular capillary wall. Immunofluorescence showed co-dominant strong coarse granular immunostaining of IgA, IgG and C3 mainly along the glomerular capillary wall. On electron microscopy some large subepithelial hump-shaped deposits were present. In summary, this case demonstrates the presence of a broad spectrum of glomerular histological findings in postinfectious glomerulonephritis.

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Section: Discussionmentioning

confidence: 99%

An unusual case of IgA-dominant postinfectious glomerulonephritis: a case report and review of the literature

Wągrowska-Danilewicz

Danilewicz²,

Fisiak³

et al. 2016

pjp

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“…There is a male predominance of 3.9:1, which is higher than the male-to-female ratio of 2:1 reported for poststreptococcal glomerulonephritis [19]. Most patients were Caucasian (53%) and Asian (26%), although a few African Americans, Hispanics and Native Americans with this disease have also been described [3,7,8,9,10,11,12,13,14]. Underlying diabetes mellitus was present in 27 patients (55%).…”

Section: Clinical Features Of Iga-dominant Apignmentioning

confidence: 93%

“…We termed this novel immunopathologic form of APIGN ‘IgA-dominant APIGN’ [6]. To date, 49 cases of IgA-dominant APIGN have been reported in the English literature, 24 of which were from our group [3,6,7,8,9,10,11,12,13,14]. Most of the reports originated from the US, Japan and Taiwan.…”

Section: Introductionmentioning

confidence: 99%

IgA-Dominant Postinfectious Glomerulonephritis: A New Twist on an Old Disease

2011

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IgA-dominant acute postinfectious glomerulonephritis (APIGN) is an increasingly recognized morphologic variant of APIGN, particularly in the elderly. In contrast to classic APIGN, in which there is typically glomerular deposition of IgG and C3 or C3 only, IgA is the sole or dominant immunoglobulin in IgA-dominant APIGN. Because the vast majority of reported cases occur in association with staphylococcal infections, the alternative designation ‘IgA-dominant acute poststaphylococcal glomerulonephritis’ has been applied. Diabetes is a major risk factor, likely reflecting the high prevalence of staphylococcal infection in diabetics, particularly involving skin. Patients typically present with severe renal failure, proteinuria and hematuria. Prognosis is guarded with less than a fifth of patients fully recovering renal function. This variant of APIGN must be distinguished from IgA nephropathy. Features that favor IgA-dominant APIGN over IgA nephropathy include initial presentation in older age or in a diabetic patient, acute renal failure, intercurrent culture-documented staphylococcal infection, hypocomplementemia, diffuse glomerular endocapillary hypercellularity with prominent neutrophil infiltration on light microscopy, stronger immunofluorescence staining for C3 than IgA, and the presence of subepithelial humps on electron microscopy. The pathogenetic mechanism of selective IgA deposition in patients with poststaphylococcal glomerulonephritis likely involves specific host responses to the inciting pathogen.

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“…To date, approximately 80 cases of IgA-dominant PIGN have been reported (1,2,4,(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). To the best of our knowledge, only 3 cases of IgA-dominant PIGN caused by E. coli infection have been reported (4,7).…”

Section: Discussionmentioning

confidence: 99%

IgA-dominant Postinfectious Glomerulonephritis Associated with <i>Escherichia coli</i> Infection Caused by Cholangitis

et al. 2014

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A 76-year-old man with a history of type 2 diabetes mellitus was admitted with cholangitis caused by cholangiocarcinoma. Cholangitis with Escherichia coli (E. coli) bacteremia recurred due to the unstable bile drainage. At 1 month after recurrence, rapidly progressive glomerulonephritis with nephrotic syndrome was manifested. Renal biopsy findings were consistent with immunoglobulin A (IgA)-dominant postinfectious glomerulonephritis (PIGN). After ensuring that the recurrent cholangitis was controlled by drainage and antibiotic therapy, oral prednisolone was initiated, and the patient's renal function and proteinuria subsequently gradually improved. This is the first case report of IgA-dominant PIGN associated with cholangitis caused by E. coli infection.

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IgA Deposits and Acute Glomerulonephritis in a Patient With Staphylococcal Infection

Cited by 22 publications

References 11 publications

An unusual case of IgA-dominant postinfectious glomerulonephritis: a case report and review of the literature

An unusual case of IgA-dominant postinfectious glomerulonephritis: a case report and review of the literature

IgA-Dominant Postinfectious Glomerulonephritis: A New Twist on an Old Disease

IgA-dominant Postinfectious Glomerulonephritis Associated with <i>Escherichia coli</i> Infection Caused by Cholangitis

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