Abstract
IgA nephropathy (IgAN) is the most common form of glomerulonephritis worldwide and in Japan. However, even within Japan, the therapeutic approach and its timing are different between childhood and adult IgAN.
We have previously compared both histology and leukocyte accumulation in biopsies of recently diagnosed childhood and adult IgAN, and found that glomerular hypercellularity owing to increased cells in mesangial area was prominent in pediatric IgAN and significantly greater than in adult IgAN. In contrast, glomerular matrix expansion and interstitial damage were more severe in adult compared to pediatric IgAN. Glomerular and interstitial activated macrophages were identified in both pediatric and adult IgAN, being significantly greater in number in adult IgAN. These findings suggested that activated macrophages are implicated in the pathogenesis of the chronic lesions of IgAN.
Our data suggest that adult onset IgAN required more early diagnosis and treatment targeting activated macrophage than that for pediatric IgAN. The importance of physical examination and its enlightenment for people should be more encouraged.
