Clinicopathological and prognositic analysis of asymptomatic IgA nephropathy in children
- VernacularTitle:儿童无症状尿检异常IgA肾病的临床病理和预后分析
- Author:
Qi CAO
;
Hong XU
;
Wenyan HUANG
;
Lijun ZHOU
;
Qian SHEN
- Publication Type:Journal Article
- Keywords:
Child;
Glomerulonephritis,IgA;
Pathology;
Prognosis
- From:
Chinese Journal of Nephrology
2008;24(5):324-327
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the clinicopathological characteristics and prognosis of asymptomatie IgA nephropathy (IgAN) children with pmteinuria and/or microscope haematuria .Methods Clinical and pathological characteristics of 54 children with IgA nephropathy confirmed by renal biopsy were analyzed . These children with IgAN were divided into two groups according to their clinical characteristics at the first onset: asymptomatic IgAN group (AsIgAN) and symptomatic IgAN group (SIgAN) . Histologic changes were classified by Lee SM and Katafuchi semiquantitative scoring system . Results Eighteen children were in AslgAN group and 36 children were in SIgAN group . The degree of proteinuria in SIgAN group [(2 .3±2 .2) g/d] was higher than that in AslgAN group [(0 .4±0 .3) g/d] at the time of biopsy (P＜0 .05) . Although asymptomatic IgAN children were mainly of Lee's type Ⅰ ～Ⅱ, 2 children (11%) were of Lee's type Ⅳ～Ⅴ and 5 cases (27%) presented interstitial injury . Symptomatic IgAN children were mainly of Lee's type Ⅱ ～Ⅲ, there was no significant difference between two groups (P＞0 .05) . Urine micrealbumin was increased in 87% children presented with microscope haematuria . After an average of (26 .9±8 .8)months follow-up, only one case of Lee's Ⅴ progressed into renal failure and the others maintained normal renal function . Conclusions Although children with asymptomatic IgAN have minor clinical symptoms, severe renal pathological lesion and poor prognosis also occur . Urine screening helps to detect renal diseases and renal biopsy should be performed in the patients with increased urine microalbumin .
