Ten Cases of Immunoglobulin A Nephropathy with an Onset of Acute Glomerulonephritis / 实用儿科临床杂志

ABSTRACT

Objective To analyze the clinical features of immunoglobulin A(IgA) nephropathy(IgAN) occurring in the context of pre-vious acute glomerulonephritis.Methods The clinicopathologic features of 108 cases(77 males,31 females,aged 3.2 to 14.0 years old) of IgAN were analyzed restrospectively with the onset of acute glomerulonephritis in this department from Jan.1994 to Dec.2005.Results Of 108 cases with IgAN,10 cases were with the onset of acute glomerulonephritis. All the 10 cases presented with edema, hematuria and proteinuria.Eight cases had macroscopic hematuria, lasting for 2 days to 2 months.Four cases had recurrent macroscopic hematuria,microscopic hematuria lasting for 16 months.Urine protein qualitative +-+++ lasted for 1-8 months.Two cases had hypertension;2 cases had increasing blood uria nitrogen and serum creatinine.The increase of anti-streptolysin O(ASO) titer was detected in 5 of 9 cases.Two cases had a high titer of DNase-B antibody, and 4 cases had hypocomplementemia.Eight cases had prodromal infection with an interval time varying from 1 to 5 days.Renal biopsies revealed mesangial proliferative glomerulonephritis in 9 cases and focal segmental glomerulosclerosis in 1 case, all with mesan-gial IgA deposition.Conclusions The interval time between the prodromal infection and nephritis symptoms is mostly short in IgAN with the onset of acute glomerulonephritis, while macroscopic and microscopic hematuria remain a fairly long time or recurrently aggravate. Renal biopsy is necessary to diagnose IgAN for this kind of children.