Clinical And Pathological Analysis Of Childhood Patients With Primary IGA Nephropathy

Objective:Primary IgA nephropathy(IgAN) is characterized by a highly variable ranging from a totally benign condition to rapidly progressive renal failure.This article's object is to investigate and analyse the IgAN's clinical and pathological characteristies and their relationship in children.Methods:Inquiry the IgAN patients that were diagnosed by kidney-puncture from January 1,2003 to March 31,2009,in children's hospital of Chongqing MedicalUniversity.The data were collected and analyzed by statistical software of SPSS 16.0.Results:(1)From January 1 2003 to March 31 2009 ,132 hospitalized children were diagnosed as IgAN by kidney-puncture.The cases of childhood lgAN accounted for l4.72% of those who underwent renal biopsies,26.45% of primary glomerular disease,being next only to mesangial proliferative glomerulonephritis.Complete records were available for 126 patients .(2)The male to female ratio was 2.15:1.The ages at the disease onset were(9.12±3.20)years.The ages at the disease diagnosis wer(e9.68±3.1)years.The course of the disease wa(s6.77±11.56)months.(3)43.65% of patients had predisposing causes,especially infection:respiratory infection is most common predisposing causes .(4)The most common"chief complaint"of the patient is macroscopic hematuria(with or without edema),its proportion is 50.79 %.Nephritic syndrome(31.35%) was the most common clinical manifestation,followed by isolated hematuria(22.22%) and the type of hematuria and proteinuria(21.43%).(5)Subclass III(40.5%) were the most common histologie types.The main type of immune-complex deposition was IgA+IgM+(C3).There is relationship between pathological lesion extent and the degree of deposited IgA in the mesangial region .With the degree of IgA deposition increases,the pathological classification increases,and the degree of complement component 3 deposition increases,too. (6) There is no significant distinction of pathological lesion distribution in different clinical type. There is more complement component 3 deposition in the group of proteinuria than the group of haematuria. With the level of proteinuria increasing, the deposition of complement component 3 in the mesangial region aggravates,too. (7)There is relationship between different pathological lesion extent,clinical type and degree of tubulointerstitial damage .With the degree of pathological lesion increasing,the degree of tubulointerstitial damage increasing,too.As the degree of tubulointerstitial damage aggravates, the level of creatinine is increasing.Conclusion:(1)The patients of boys far more than girls(2.15:1).(2)Nephritic syndrome(NS) was the most common clinical manifestation.(3) Subclass III are the most common histologic type.The main type of immune-complex deposition is IgA+IgM+(C3) . There is relationship between the degree of pathological lesion with the intensity of IgA deposited in the mesangial region.With the degree of IgA deposition increases,the degree of complement component 3 deposition increases.(4) There is no corresponding relationship between pathological lesion and clinical type. Deposited complement component 3 in the mesangial region is heavier in the group of proteinuria than the group of haematuria.Deposition of complement component 3 in the mesangial region may lead to injure of podocyte, consequently cause proteinuria. (5) There is relationship between tubulointerstitial damage and pathological lesion,clinical type.With pathological lesion increasing, tubulointerstitial damage aggravates.