Mesangial immunoglobulin A deposits in minimal change nephrotic syndrome: a report of an older patient and review of the literature

American Journal of Nephrology
D M CliveF G Silva

Abstract

A 57-year-old patient with a history of monoclonal immunoglobulin A (IgA) gammopathy developed idiopathic nephrotic syndrome. Renal biopsy showed minimal glomerular changes with predominant glomerular mesangial IgA. The association of glomerular mesangial IgA with otherwise typical minimal change nephrotic syndrome has been noted before, and the literature concerning this combination of findings is reviewed. The patient herein described represents one of the two oldest patients yet reported with this syndrome and raises questions about the relationship between minimal change disease and IgA nephropathy. Severe proteinuria (and even the nephrotic syndrome) is not necessarily the harbinger of a poor prognosis in IgA nephropathy if the glomerular morphology is otherwise consistent with minimal change nephrotic syndrome. Such patients should be treated in a fashion similar to those with minimal change nephrotic syndrome. The significance of the IgA gammopathy in the pathogenesis of this case is unknown.

Citations

May 31, 2003·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·M Barry StokesVivette D D'Agati
Apr 28, 2006·Kidney International·J Barratt, J Feehally
Jan 29, 2008·Seminars in Nephrology·David PhilibertTerence Cook
Aug 30, 2002·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Rosanna CoppoUNKNOWN European IgACE Study Group
Mar 17, 2015·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Zhijuan KangYan Yin
Apr 12, 2014·Clinical Journal of the American Society of Nephrology : CJASN·Leal C HerlitzGlen S Markowitz

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