Open AccessThe importance of immunoglobulin A nephropathy early diagnosis and management – case report
Author(s) -
Georgiana Aurelia Nae,
Mihai-Emil Gherghina,
Ileana Peride,
Mirela Țigliș,
Tiberiu Paul Neagu,
Andrei Niculae
Publication year - 2021
Publication title -
romanian medical journal
Language(s) - English
Resource type - Journals
eISSN - 2069-606X
pISSN - 1220-5478
DOI - 10.37897/rmj.2021.4.27
Subject(s) - medicine , renal biopsy , proteinuria , renal function , nephrotic syndrome , nephropathy , microscopic hematuria , mesangium , glomerulonephritis , asymptomatic , nephritic syndrome , gastroenterology , glomerular mesangium , immunology , pathology , kidney , endocrinology , diabetes mellitus
Immunoglobulin A (IgA) nephropathy is one of the most common glomerulonephritis. Its clinical manifestations vary from asymptomatic forms to cases with nephritic syndrome or nephrotic-range proteinuria. The prognosis depends on the level of proteinuria, decline of glomerular filtration rate and control of blood pressure. The pathognomonic histological changes are represented by the granular IgA deposits in the mesangium. The treatment consists of comprehensive support care and immunosuppressive therapy. We discuss the case of a 50-year-old man who presented microscopic hematuria, nephrotic-range proteinuria and decreased renal function, exacerbated in the last 6 months prior the admission. We performed a renal biopsy and granular deposits were present in the glomerular mesangium that were highly suggestive for IgA nephropathy. Immunosuppressive therapy was instituted immediately, but the decline of the renal function continued and renal replacement therapy was needed. Patients with poor prognosis have an unsatisfactory response to the immunosuppressants, especially those with a delayed diagnosis.