Analysis of Clinical and Pathological Features of 72 Children with IgA Nephropathy

Objective To explore the clinical and pathological features of IgA nephropathy(IgAN) in children and analyze their mutual relationships. Methods The clinical manifestations,clinical types,pathohistological and immunological changes and their mutual relationships of 72 children with IgAN confirmed by renal biopsy were analyzed retrospectively,who were admitted in Xi′an Children′s Hospital from May 2005 to Aug.2011. Results Among 72 children,48 children were male and 24 children were female,and the average age of the children was(8.99±2.94) years and the average course of disease at admission was 12.86 months.The onset of disease was hematuria in 58 patients(including gross hematuria of 38 patients and hematuria associated with edema of 5 patients),simple edema in 12 patients and simple proteinuria in 2 patients.As for clinical types,isolated hematuria type was detected in 19 patients(26.39%),isolated proteinuria type in 2 patients(2.78%),hematuria-proteinuria type in 13 patients(18.05%),acute nephritis type in 10 patients(13.89%) and nephrotic syndrome type in 28 patients(38.89%).As for pathologic changes,40 patients showed mesangial proliferative glomerulonephritis,6 patients with endocapillary proliferative glomerulonephritis,25 patients with focal proliferative glomerulonephritis,and only 1 patient had crescentic glomerulonephritis.Seventeen patients had crescent formation(23.61%).Immunohistochemistry showed that all kinds of immunoglobulins deposits could be observed:IgA deposit in 8 cases,IgA+IgG+C3 deposit in 2 cases,IgA+IgM+C3 combined deposit in 44 cases,IgA+IgM+IgG+C3 combined deposit in 17 cases,full-house type deposit in 1 case only. Conclusions The clinical manifestations of patients with IgAN are diverse,and severity of the disease is not related to the types of onset.The common pathological diagnosis is mesangial proliferative glomerulonephritis,and the common immunoglobulin deposit type is combined deposit types.Those patients who were presented with nephrotic syndrome or hematuria and proteinuria both have more severe pathology,so their renal biopsy should be performed as soon as possible and effective treatment shall be given timely.