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General Reference

Nejm 2002;347:738; 1998;339:890; 1994;331:1194

Pathophys and Cause

Cause:Altered regulation of production or structure of IgA

Pathophys:IgA immune complexes deposited in glomeruli, diffuse mesangial deposits; Henoch-Schönlein purpura similar morphologically, maybe etiologically

Epidemiology

High prevalence in western Pacific Rim, low in US and Europe; M > F, esp under age 25 yr; most common form of GN worldwide, most common cause of asx hematuria

Signs and Symptoms

Sx:Goss hematuria, esp assoc w URI or gastroenteritis

Si:Hematuria (60%), asx (30%); AGN, or nephrotic syndrome (10%)

Course

20-40% progress to chronic renal failure

Lab and Xray

Lab:

Serol:Elevated IgA levels

Urinanalysis:Hematuria, proteinuria

Treatment

Rx: Fish oil; ACE inhibitors; steroids