1985 Volume 27 Issue 11 Pages 1503-1514
Some cases of glomerulonephritis show the mesangial proliferation like IgA nephropathy (IgA) without IgA depositions in immunof luorescence technique. The author classified these cases as non-IgA nephropathy (non-IgA), and then, studied it in comparison with IgA from the following two viewpoints. (I) Comparison of clinical and histological pictures between IgA and non-IgA Of 748 cases in total, 210 were of IgA and 44 non-IgA. Severe hematuria, especially macroscopic one, was observed more frequently in the former than in the latter. No differences between the two diseases were recognized in the frequency of chance proteinuria/ hematuria and in high serum IgA values, though these parameters have been regarded as characteristics of IgA. IgA revealed more frequently focal / segmental lesions under light microscopy, and alterations of capillary loops as well as hemispherical mesangial deposits by electron microscopy than non-IgA. By immunof luorescence technique, it was proved that non-IgA was composed of various diseases, (II) Comparative prognostic study A retrospective review for declining renal function was made between 60 IgA cases with mild mesangial proliferation and 13 non-IgA patients with the same histological changes in degree. IgA showed more frequently the deterioration of renal function during the follow-up period. The ages of patients and the presence of vascular changes at the time of renal biopsy were described previously as the factors of poor prognosis in IgA. On the contrary, they were observed more frequently in non-IgA than in IgA. Therefore, they were not concerned with poor prognosis of IgA. The focal / segmental lesions, especially segmental sclerosis, observed more frequently in IgA, might constitute such a prognostic factor.
