| Idiopathic IgA Nepropathy in Children. |
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Hae Il Cheong1, Han Wook Yoo2, Kwang Wook Ko2 |
1Department of Pediatrics, Seoul Red Cross Hospital
2Department of Pediatrics, College of Medicine, Seoul National University |
| 소아에 있어서의 특발성 IgA 신병증 |
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정해일1, 유한욱2, 고광욱2 |
1서울적십자병원 소아과
2서울대학교 의과대학 소아과학교실 |
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| Abstract |
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We analyzed clinical findings, pathological findings and clinico-pathological correlations in 55 children with idiopathic IgA nephropathy confirmed immunopathologically, and the results were as follows;
1) The mean age at onset was 9.65±2.45 years with relatively even distribution in school ages and males
outnumbered females by 1.75 : 1.
2) The main mode of presentation was typical recurrent gross hematuria in 29(52.7%), and the next was
nephrotic syndrome in 10(18.2%).
3) Nephrotic range of proteinuria and elevated serum IgA levels were observed in 34.5% and 25.5% of cases,
respectively.
4) Light microscopically, 30 cases(54.5%) showed mesangial proliferation with less than 50%
crescents/segmental lesions, 16 cases(29.1%) did pure mesangial proliferation and cases (14.5%) did minor
change.
5) Immunofluorescent microscopically, IgA+C3 or IgA+IgG+C3 combination of mesangial deposits was the most
common and in 7 cases (12.7%) capillary staining of IgA was accompanied.
6) Electron microscopically, 52.9% showed only mesangial electron dense deposits and 41.2% did mesangial
deposits with variable combinations of subendothelial, subepithelial and intramembranous deposits. In 5.9%
of cases, no deposits were found.
7) U/A findings between gross hematuric episodes showed no microscopic hematuria and HQ proteinuria in
30.9%, microscopic hematuria without proteinuria in 40.0% and proteinuria with/without microscopic
hematuria in 29.1% of cases.
8) During follow-up, 2 cases expired due to ARF and CRF, each, and another 2 became the state of mild renal
insufficiency.
9) More severe form of mode of presentation, heavy proteinuria or accompanying tubulointerstitial changes
was noted more frequently in those with more severe glomerular changes.
And each of such findings as initial hypertension, initial azotemia, accompanying loin pain, presence of
proteinuria between gross hematuric episodes and accompanying capillary stain-ing of IgA in
immunofluorescent study was revealed as a poor prognostic indicator so far as the maintenance of normal
renal function was concerned.
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| Key Words:
IgA nephropathy, Children, Clinico-pathological correlation, Prognostic indicator |
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