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IgA dominant postinfectious glomerulonephritis: Report of two cases.

Rajakumar V, Mohamed SA, Kurien AA, Fernando ME - Indian J Nephrol (2014)

Bottom Line: We encountered two cases of IgA dominant PIGN recently presenting as rapidly progr essive glomerulonephritis and managed conservatively.Both the patients are on follow-up and do not have complete recovery of renal function till date.Long-term follow-up is needed to assess the progression of the disease in these patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, Government Stanley Medical College, Chennai, Tamil Nadu, India.

ABSTRACT
Immunoglobulin A (IgA) dominant postinfectious glomerulonephritis (IgA PIGN) is a distinct clinical entity increasingly recognized in adult. It usually presents with reduced glomerular filtration rate, heavy proteinuria, and has unfavorable prognosis. Immunofluorescence study of renal biopsy specimens have IgA as dominant or codominant antibody. We encountered two cases of IgA dominant PIGN recently presenting as rapidly progr essive glomerulonephritis and managed conservatively. Both the patients are on follow-up and do not have complete recovery of renal function till date. Long-term follow-up is needed to assess the progression of the disease in these patients.

No MeSH data available.


Related in: MedlinePlus

Intense (+3) coarse granular positivity for C3 along the capillary walls (IF, ×20)
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Figure 5: Intense (+3) coarse granular positivity for C3 along the capillary walls (IF, ×20)

Mentions: A 37-year-old gentleman was admitted with oliguria, swelling of legs, and breathlessness for 10 days; preceded by upper respiratory tract infection 1 week back. On clinical examination, he had pedal edema and hypertension. Urinalysis showed protein 3+ and blood 3+ and urine spot protein/creatinine ratio (PCR) 7.89. Investigations showed a hemoglobin of 9 gm/dl, WBC count 5,500/mm3(polymorphs 61%, lymphocytes 33%, and others 6%), platelets 3 lakhs/mm3, and serum creatinine progressed from 1.1 to 4.3 mg/dl over a period of 8 days. Serology showed HBsAg, HCV, and HIV negative; complements C3 39.7 mg/dl (79-152 mg/dl) and C4 17.1 mg/dl (16-38 mg/dl); ASO positive; and ANA negative. Blood culture showed no growth. Renal biopsy was done; LM showed 14 glomeruli, all with global endocapillary proliferation with neutrophilic infiltration; partial cellular crescents in four glomeruli; patchy interstitial inflammatory infiltrate; normal vessels [Figure 4]. IF showed +3 coarse granular positivity for C3 over the mesangium and capillary walls with weaker (+1) positivity of IgA and IgM. Staining for IgG and C1q were negative [Figures 5 and 6].


IgA dominant postinfectious glomerulonephritis: Report of two cases.

Rajakumar V, Mohamed SA, Kurien AA, Fernando ME - Indian J Nephrol (2014)

Intense (+3) coarse granular positivity for C3 along the capillary walls (IF, ×20)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4127840&req=5

Figure 5: Intense (+3) coarse granular positivity for C3 along the capillary walls (IF, ×20)
Mentions: A 37-year-old gentleman was admitted with oliguria, swelling of legs, and breathlessness for 10 days; preceded by upper respiratory tract infection 1 week back. On clinical examination, he had pedal edema and hypertension. Urinalysis showed protein 3+ and blood 3+ and urine spot protein/creatinine ratio (PCR) 7.89. Investigations showed a hemoglobin of 9 gm/dl, WBC count 5,500/mm3(polymorphs 61%, lymphocytes 33%, and others 6%), platelets 3 lakhs/mm3, and serum creatinine progressed from 1.1 to 4.3 mg/dl over a period of 8 days. Serology showed HBsAg, HCV, and HIV negative; complements C3 39.7 mg/dl (79-152 mg/dl) and C4 17.1 mg/dl (16-38 mg/dl); ASO positive; and ANA negative. Blood culture showed no growth. Renal biopsy was done; LM showed 14 glomeruli, all with global endocapillary proliferation with neutrophilic infiltration; partial cellular crescents in four glomeruli; patchy interstitial inflammatory infiltrate; normal vessels [Figure 4]. IF showed +3 coarse granular positivity for C3 over the mesangium and capillary walls with weaker (+1) positivity of IgA and IgM. Staining for IgG and C1q were negative [Figures 5 and 6].

Bottom Line: We encountered two cases of IgA dominant PIGN recently presenting as rapidly progr essive glomerulonephritis and managed conservatively.Both the patients are on follow-up and do not have complete recovery of renal function till date.Long-term follow-up is needed to assess the progression of the disease in these patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, Government Stanley Medical College, Chennai, Tamil Nadu, India.

ABSTRACT
Immunoglobulin A (IgA) dominant postinfectious glomerulonephritis (IgA PIGN) is a distinct clinical entity increasingly recognized in adult. It usually presents with reduced glomerular filtration rate, heavy proteinuria, and has unfavorable prognosis. Immunofluorescence study of renal biopsy specimens have IgA as dominant or codominant antibody. We encountered two cases of IgA dominant PIGN recently presenting as rapidly progr essive glomerulonephritis and managed conservatively. Both the patients are on follow-up and do not have complete recovery of renal function till date. Long-term follow-up is needed to assess the progression of the disease in these patients.

No MeSH data available.


Related in: MedlinePlus