Analysis Of Clinical And Pathological Features In 281 Cases With IgA Nephropathy

Objective:To study the clinical features and pathologic changes of IgAnephropathy and their relationships.Methods:281 IgA patients from the 2nd Xiang Ya hospital of Central Southuniversity which had been diagnosed by renal biopsy between Oct 2003and Sept 2006 were reviewed. All of the clinical and pathologicinformation were analyzed by SPSS 13.0.Results:1. According to our information, the onset of IgA nephropathygenerally occoured in young adults especially 21-30 years old (mean age31.6±1.5 years), with the ratio of male to female 1:1.13, body weight57.0±10.2kg, city-dwellers outnumbering country-dwellers 1.65:1.Course of the disease was 21.3±41.3 months. Infection especiallyrespirative infection in initiating this disease was obviously (53.4%),among wich tonsillitis was the most responsible (35.9%). Heamaturia andproteinuria were the most clinical manifestations. Heamaturia wassignificantly more and proteinuria significantly less in woman than inmen. Hypertension was much more common in elderly patients (P＜0.05or P＜0.01). 2. Mesangial proliferation was the most magnificent in pathologicalinjure and mesangial proliferation glomerulonephritis (MSPGN) was themost common type in histological change (P＜0.01). TypeⅢwas themost one and typeⅠand type Vare relatively less in Lee's Grading(P＜0.01). Direct immunoinfluorescence showed IgA depositedprominently at mesenterium mostly in lower grade of Lee's and atmesenterium plus capillary loop in higher grade (P＜0.05 or P＜0.01).There was no significant difference in composition of IgA with or withoutIgG, IgM, C3, Clq and FRA among each pathological grade (P＞0.05).Most of IgA deposition degree was++(P＜0.05). There was norelationship between intensity of IgA desposition and pathological grade(P＞0.05).3. The propotion of serum critinine and urine protein quanfitationsteped up gradually according with higher pathological levels amongwhich there were significant differences (P＜0.05 or P＜0.01). There wereno signifficant differences about Elevating serum IgA and decendingserum C3 among defferent groups in Lee's Grading (P＞0.05).4. Acording to higher Lee's grade, hypertension, abnormal renalfunction, middle to severe proteinura or proteinufia plus heamaturiaincreased gradually and mild proteinuria or merely heamaturia decreasedgradually. There were significant differences among groups (P＜0.05 orP＜0.01). Conclusions:1. The onset of IgA nephropathy was prone between age of 21-30years. Infection especially respirative infection was the most initiatingcause.2. Clinical manifestations were various. Hypertension occuredpronely in elder patients. Proteinuria occurred pronely in male patientsbut heamaturia in female patients.3. Mesangial proliferation was the main magnificent in pathologicalinjure and mesangial proliferation glomerulonephritis (MSPGN) was themain type in pathological change and typeⅢwas the most one in Lee'sGrading. Direct immunoinfluorescence with IgA deposition prominentlyat mesenterium plus capillary loop was relatively more severe, but theintensity of the desposition was independent.4. there were no linkages between Elevating IgA or decending C3 inserum and pathological changes or IgA deposition intensity in our study.