The Introduction of IgA Nephropathy

IgA Nephropathy, also known as Berger’s disease, is a special form of glomerulonephritis, which often happens to children and young adults. Before the attack, many patients would have upper respiratory tract infection. The pathological characteristics are the glomerular mensangial proliferation. Through immunofluorescence method, the deposit of IgA can be seen in the mesangial area.
IgA Nephropathy is chronic glomerular disease which is caused by various pathogenesis but shows the same immunopathological characteristics. The clinical manifestations are also varied, with hematuria the major symptom, which is accompanied by different levels of proteinuria, hypertension and impaired kidney function. IgA Nephropathy is a common primary glomerulonephritis that leads to kidney failure. Approximately, about 40% to 50% of the patients present gross or microscopic hematuria, and 35% to 40% of the patients present microscopic hematuria and proteinuria, while the rest present nephrotic syndrome and kidney failure.
Worldwide, IgA Nephropathy is a very common glomerulenephritis. In Asian and Pacific region, IgA Nephropathy is the most common primary glomerunephritis, accounting for 30% to 40% of the patients taking renal biopsy. In China, IgA Nephropathy accounts for 40 to 47.2% of the primary glomerulonephritis and it is in an upward tread in recent years.
So far, the precise pathological mechanism is not clear. Many factors are involved in the making and progression of this disease. The synthetization, release and existence of IgA1 molecule(the immunoglobin deposited in the glomerular mesangial area) in the peripheral blood, its combination with mesangial cells and its deposition, and the following inflammatory response, are the characteristic pathogenic process of IgA Nephropathy. The chain response, such as the cell proliferation of glomerular cells, the hardening of glomeruli, the atrophy of tubules and the fibrosis of the interstitium are the route shared by all types of glomerulonephritis.
The clinical manifestation of IgA Nephropathy that patients could present include:
1. intermittent gross hematuria
This symptom tends to happen to children. It usually happens in the aftermath of upper respiratory tract infection( such as tonsillitis). The gross hematuria can persist for several hours to several days. Then it would change into microscopic hematuria, even disappears in some cases.
2.microscopic hematuria with asymptomatic proteinuria
These are the major clinical manifestations of children and teenagers with IgA Nephropathy, which are usually spotted during physical examinations.
3.proteinuria
The level is light, and the UPQ(Urine Protein Quantitation) is usually less than 1g/24h. In a few cases, gross proteinuria even nephrotic syndrome could happen.
4. other symptoms
Some patients can present acute nephritic syndrome, kidney failure, with few presenting severe abdominal pain and hematuria.

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