Case
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Diagnosis: IgA Nephropathy (with Membranoproliferative Pattern)
IgA nephropathy can give many patterns of glomerular lesions. Although the most commonly described histological alteration is mesangial proliferation, there can be as many glomerular lesions as in lupus nephritis; we can find normal glomeruli, segmental and focal, or global and diffuse hypercellularity, extracapillary proliferation, necrotizing lesions, focal and segmental glomerulosclerosis and membranoproliferative GN pattern, such as the case we present. Currently, the presence of subendothelial deposits in IgA nephropathy is considered to have prognostic implications, since it is related to a higher degree of inflammation and glomerular damage.
See the chapter: IgA Nephopathy of our Tutorial
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References
- Hidaka Y, Tamura H, Furuie K, Kuraoka S, Nagata H, Nakazato H. Cyclosporine therapy could be considered for membranoproliferative glomerulonephritis with immunoglobulin A deposits: a case report. BMC Nephrol. 2022;23(1):358. [PubMed link].
- Shima Y, Nakanishi K, Mukaiyama H, Tanaka Y, Wada T, Tanaka R, Kaito H, Nozu K, Sako M, Iijima K, Yoshikawa N. Clinicopathological significance of glomerular capillary IgA deposition in childhood IgA nephropathy. Pediatr Nephrol. 2021;36(4):899-908. [PubMed link]
- Takada D, Sumida K, Sekine A, Hazue R, Yamanouchi M, Suwabe T, Hayami N, Hoshino J, Sawa N, Takaichi K, Fujii T, Ohashi K, Ubara Y. IgA nephropathy featuring massive wire loop-like deposits in two patients with alcoholic cirrhosis. BMC Nephrol. 2017;18(1):362. [PubMed link]
- Yamaji K, Suzuki Y, Suzuki H, Satake K, Horikoshi S, Novak J, Tomino Y. The kinetics of glomerular deposition of nephritogenic IgA. PLoS One. 2014;9(11):e113005. [PubMed link]