Immunoglobulin-A distribution in glomerular disease: Analysis of immunofluorescence localization and pathogenetic significance

Hyman, Lawrence R.; Wagnild, Jon P.; Beirne, Gregory J.; Burkholder, Peter M.

doi:10.1038/ki.1973.62

Cited by 62 publications

(17 citation statements)

References 10 publications

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“…It is now recognized that the clinical presen tations of IgA nephropathy are varied, ranging from asymptomatic urinalysis abnormalities to acute renal failure [1-4, 15, 18]. Although macroscopic haematuria is widely held to be the most common presenting symptom [3][4][5]7], it accounted for only 38% of presentations in this series. Abnormalities of urinalysis with or without hypertension were responsible for the majority of patient referrals in this study, as was the case in other reports of IgA disease in Australia [1,18].…”

Section: Discussionmentioning

confidence: 84%

Clinicopathological Associations in Mesangial IgA Nephropathy

Boyce¹,

Holdsworth²,

Thomson

et al. 1986

Am J Nephrol

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On hundred and fifteen renal biopsies performed in 112 patients with mesangial IgA nephropathy were reviewed and the histological disease patterns correlated with the clinical features at the time of initial biopsy. To determine the significance of macroscopic haematuria in this disease, specific comparisons were made between patients with a history of episodes of macroscopic haematuria and those with only microscopic haematuria. The mean age at initial biopsy was 38.3 years (90 males, mean 40.3 years; 22 females, mean 30.2 years). Histological examination showed 9 patients (8%) with class I disease (mesangial matrix expansion alone); 43 patients (38%) with class II disease (diffuse mesangial proliferation); 60 patients (54%) with class III disease (focal and segmental proliferation), including subsets of 20 patients (16%) with segmental sclerosis and/or synechiae and 23 patients (21 %) with crescent formation. Class III disease and crescent formation correlated with an increased frequency of capillary loop IgA and glomerular fibrin deposition and with the presence of subendothelial and subepithelial deposits. The degree of renal impairment and the incidence of hypertension were increased in class III disease. Macroscopic haematuria patients were younger (mean 31.1 vs. 43.0 years; p < 0.001), had less severe renal impairment (mean creatinine 116.2 vs. 213.3 μmol/l; p < 0.001) and less class III disease (48 vs. 58%; p < 0.05). The incidence of crescentic disease was equal in macroscopic (17%) and microscopic (23%) haematuria. Eventual progression to end-stage renal failure occurred in 12 patients (11 %) and correlated with crescentic disease, renal impairment, hypertension and heavy proteinuria at the time of diagnosis. There were no adverse clinical, histological or prognostic associations in patients with macroscopic haematuria.

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Section: Discussionmentioning

confidence: 84%

Clinicopathological Associations in Mesangial IgA Nephropathy

Boyce¹,

Holdsworth²,

Thomson

et al. 1986

Am J Nephrol

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“…In Singa pore it is the most common type of adult primary glomer ular lesion accounting for 33.7% of the cases [10]; and in France and Italy IgA nephropathy is found in 20-25% of adult patients with idiopathic glomerulonephritis [3,[11][12][13]. A higher incidence of 35-40% has been reported from Japan [14][15][16], However, lower incidences ranging from 1.5 to 10% have been recorded in Britain, the United States, and Canada [17][18][19][20][21][22], The reason for this wide variation is not clear. It may be related in part to the criteria of patient inclusion or selection for renal biopsy.…”

Section: Frequency Of Iga Nephropathymentioning

confidence: 99%

IgA Mesangial Nephropathy: Bergers Disease

Sinniah¹

1985

Am J Nephrol

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“…Mesan gial IgA deposition occurs most commonly in the context of an intercurrent respiratory infection, although it has also been reported associated with Henoch-Schonlein purpura, the nephritis of systemic lupus erythematosus, and in chronic liver disease [7][8][9][10][11]. It has never been reported in association with preexistent AGN.…”

Section: Discussionmentioning

confidence: 99%

IgA Nephropathy Occurring in the Context of Previous Acute Glomerulonephritis

Yoshizawa¹,

McClung²,

Ohshima³

et al. 1986

Nephron

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A 37-year-old female presented with acute onset of glomerulonephritis 10 days following an upper respiratory infection. Serum complement components were depressed and proteinuria exceeded 3.0 g daily. Renal biopsy revealed granular staining of IgG and C3 along the basement membrane as well as small amounts of IgA in a linear pattern. Gradual resolution of symptoms was followed by recrudescent proteinuria 2 years later. Renal biopsy at this time revealed large deposits of IgA in a mesangial stainging pattern consistent with a diagnosis of IgA nephropathy. Possible mechanisms for this unusual morphologic transformation include enhanced mesangial permeability as well as mesangial sequestration of an exogenous antigen.

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Immunoglobulin-A distribution in glomerular disease: Analysis of immunofluorescence localization and pathogenetic significance

Cited by 62 publications

References 10 publications

Clinicopathological Associations in Mesangial IgA Nephropathy

Clinicopathological Associations in Mesangial IgA Nephropathy

IgA Mesangial Nephropathy: Bergers Disease

IgA Nephropathy Occurring in the Context of Previous Acute Glomerulonephritis

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