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Clinicopathologic characteristics of IgA nephropathy with steroid-responsive nephrotic syndrome

Cited 23 time in Web of Science Cited 22 time in Scopus
Authors
Kim, Sun Moon; Moon, Kyung Chul; Oh, Kook-Hwan; Joo, Kwon Wook; Kim, Yon Su; Ahn, Curie; Han, Jin Suk; Kim, Suhnggwon
Issue Date
2009-02-12
Publisher
Korean Academy of Medical Science
Citation
J Korean Med Sci. 2009 Jan;24 Suppl:S44-9. Epub 2009 Jan 28.
Keywords
AdultAgedFemaleGlomerulonephritis, IGA/complications/*diagnosisHumansKidney TransplantationKoreaMaleMicroscopy, Fluorescence/methodsMiddle AgedNephrotic Syndrome/complications/*diagnosis/therapyRemission InductionRetrospective StudiesSteroids/*therapeutic useTreatment Outcome
Abstract
Nephrotic syndrome is an unusual manifestation of IgA Nephropathy (IgAN). Some cases respond to steroid treatment. Here we describe a case-series of IgAN patients with steroid-responsive nephrotic syndrome. Twelve patients with IgAN with steroid-responsive nephrotic syndrome were evaluated and followed up. All patients presented with generalized edema. Renal insufficiency was found in two patients. The renal biopsy of eight patients revealed wide foot process effacement in addition to the typical features of IgAN. They showed complete remission after steroid therapy. Seven relapses were reported in five patients; six of the relapsed cases responded to steroid therapy. Compared with steroid-non-responsive patients, the patients with steroid-responsive nephrotic syndrome had shorter symptom duration, more weight gain, more proteinuria, and lower histologic grade than did those that had steroid-non-responsive nephrotic syndrome at presentation. None of the responders progressed to end stage renal disease, whereas five (38%) non-responders required dialysis or renal transplantation. Patients with IgAN who have steroid-responsive nephrotic syndrome likely have both minimal change disease and IgAN. The clinical features of sudden onset of generalized edema, initial heavy proteinuria and initial severe hypoalbuminemia might help identify the subset of patients, especially in low grade IgAN.
ISSN
1011-8934 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19194561

http://synapse.koreamed.org/Synapse/Data/PDFData/0063JKMS/jkms-24-S44.pdf

http://hdl.handle.net/10371/46296
DOI
https://doi.org/10.3346/jkms.2009.24.S1.S44
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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