1984 Volume 26 Issue 8 Pages 1017-1028
Clinical and pathologic features of IgA nephropathy were studied in 47 children (35 boys, 12 girls) during a mean follow-up period of 3.4 years. Renal biopsy specimens were reviewed and classified into three groups on the basis of light microscopy : (I) normal glomeruli (7 patients), (II) mesangial hypercellularity (23 patients), and (III) mesangial hypercellularity associated with synechiae formation, crescent formation or glomerular capillary collapse and sclerosis (17 patients). No significant differences were found among the three groups in age of onset, sex ratio, and known duration of the disease. Incidence and the number of episodes of macrohematuria and high serum IgA levels were not related significantly to the severity of the glomerular changes. Proteinuria of more than lg/day was associated with the more severe histologic changes (group III) and the presence of membranolysis, subendothelial and sube pithelial deposits noted by electon microscopy. Hypertension, decreased renal function were slightly more likely found in association with the more severe glomerular changes (group III), but this was not statistically significant. Tubulo-interstitial changes were also correlated with the severity of the glomerular lesions (group III). Follow-up data did not indicate a poor prognosis, however, our results suggest that heavy proteinuria and severe histological changes may be harbingers of a more serious prognosis.
