- IgA nephropathy is most often an idiopathic disorder that is characterized by asymptomatic microscopic hematuria with mild proteinuria or recurrent episodes of gross hematuria that may be concomitant with an upper respiratory infection. It is the most common glomerular cause of hematuria.
- IgA nephropathy may be associated with hepatic cirrhosis, gluten enteropathy, or dermatitis herpetiformis.
- Henoch-Schnlein purpura is a systemic vasculitis that presents with the tetrad of palpable purpura (usually in the lower trunk or extremities), abdominal pain, joint inflammation, and renal failure due to IgA nephropathy. Fewer than
- 25% of cases progress to ESRD by 20 years.
- Light microscopy is notable for increased mesangial cellularity and matrix. In severe cases crescents may form. Immunofluorescence and electron microscopy reveal mesangial deposition of IgA and C3.
- Glucocorticoids may be helpful in patients who have progressive disease.
- The use of omega-3 fatty acids, found in fish oil (6 g PO bid including 1.8 g of eicosapentaenoic acid and 1.2 g of docosahexanoic acid), may be beneficial in preventing the deterioration of renal function. Cyclophosphamide has been used in severe crescentic disease.