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Clinicopathological Findings of IgA Nephropathy in Children and Adolescents; (Multicentn Study)

Author: Alaa M. Neamah*, Ammar A. Hussein** ,Hasanein H. Ghali*** , Qutaiba A. Hussein**
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 3 Pages: 338-343
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: IgA nephropathy (IgAN) is the most common lesion found to cause primary glomerulonephritis throughout most developed countries of the world. Patients may present at any age, but there is a peak incidence in the second and third decades of life. OBJECTIVE:To study the demographic, clinical and laboratory findings of IgAN patients including children and adolescents.METHODS: The medical records of 30 patients with IgAN were retrospectively reviewed and assessed. Patients enrolled in this study were between 1-18 years old diagnosed as IgAN in the period from January 2010 to the end of December 2012 being treated and followed in the main three centers of treating cases of pediatric nephrology in Baghdad (Al-karama teaching hospital, Central Child Teaching Hospital and Baghdad Medical City) that receive referral cases from all Iraqi governorates. RESULTS: The total number of cases enrolled in this study was 30 patients, with males being 19 and females being 11. The male to female ratio was 1.72:1. Family history of chronic renal disease was found in 10 patients (33%). History of pharyngitis was found in 16 patients (53.3%). Macroscopic hematuria was found in 24 patients (80%), followed by edema in 18 patients (60%), and followed by hypertension in 15 patients (50%). The most common laboratory findings among study group was microscopic hematuria (29 patients, 96.7%), followed by proteinuria in 22 patients (73.3%). Renal biopsy was done for all patients for the diagnosis of IgAN. The distribution of histopathology staging system was: Stage (1) 14 patients, Stage (2) 8 patients, Stage (3) 5 patients, Stage (4) 2 patients and Stage (5) 1 patient (46.7%, 26.7%, 16.7%, 6.7% and 3.3% respectively). The study showed that 24 patients were found to have IgA deposited solely (80%). Out of the total 12 patients presented with hematuria, nine of them (75%) showed stage 1 disease on histopathology study. Two patients were noticed to have other associated autoimmune diseases, one with hepatitis and another with ulcerative colitis. CONCLUSION: Further studies in large number of patients are needed in order to confirm the findings in this study and to establish the best therapeutic choice for IgAN. The need for immunofluorescence examination of the renal biopsies in suspected cases is recommended.

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