IgA Vasculitis and IgA Nephropathy: Same Disease?

Abstract

Many authors suggested that IgA Vasculitis (IgAV) and IgA Nephropathy (IgAN) would be two clinical manifestations of the same disease; in particular, that IgAV would be the systemic form of the IgAN. A limited number of studies have included sufficient children or adults with IgAN or IgAV (with or without nephropathy) and followed long enough to conclude on differences or similarities in terms of clinical, biological or histological presentation, physiopathology, genetics or prognosis. All therapeutic trials available on IgAN excluded patients with vasculitis. IgAV and IgAN could represent different extremities of a continuous spectrum of the same disease. Due to skin rash, patients with IgAV are diagnosed precociously. Conversely, because of the absence of any clinical signs, a renal biopsy is practiced for patients with an IgAN to confirm nephropathy at any time of the evolution of the disease, which could explain the frequent chronic lesions at diagnosis. Nevertheless, the question that remains unsolved is why do patients with IgAN not have skin lesions and some patients with IgAV not have nephropathy? Larger clinical studies are needed, including both diseases, with a common histological classification, and stratified on age and genetic background to assess renal prognosis and therapeutic strategies.

Reactivation of IgA vasculitis following COVID-19 vaccination

“…IgA vasculitis, previously Henoch-Schönlein purpura, is the most common vasculitis in children. It presents with a purpuric rash classically affecting the lower extremities and buttocks, abdominal pain, arthralgia and glomerulonephritis, which may be histologically indistinguishable from IgA nephropathy, leading some to suggest that there may be some overlap or shared pathophysiology between the two conditions 3 4…”

IgA vasculitis with severe renal manifestation

“…Renal involvement in adults with IgA vasculitis occurs in 45%–85% cases. A Japanese study reported lower incidence of crescents on biopsy of IgA vasculitis when compared with IgA nephropathy 8…”

Pathogenesis of IgA Vasculitis: An Up-To-Date Review

“…Especially, it can hardly be distinguished from renal-limited IgAV (56,57). Similarities and differences between IgAV with nephritis and IgAN are presented in Table 1 (58,59).…”