How To Diagnose Iga Nephropathy

IgA Nephropathy is characterized by predominant deposition of IgA and antigen-antibody complexes in the mesangial area of the kidney

. Usually, IgA Nephropathy is diagnosed in 24-72 hours after an infection, especially upper respiratory infection. Therefore, to identify a IgA Nephropathy, the patient should meet the following diagnostic criteria:

1). Asymptomatic hematuria

2). With or without proteinuria

3). People who has a previous upper respiratory infection or any other infection

If the patient had met the above conditions, he/she should be suspected IgA Nephropathy. To identify IgA Nephropathy, a kidney biopsy is needed. If deposition of IgA and antigen-antibody complexes are found in the mesangial area of the kidney, then the patient can be diagnosed with IgA Nephropathy.

However, deposition of IgA in mesangial area of kidney can be found in many diseases, therefore, it is necessary to rule out them. Differential diagnosis of the following diseases is strongly recommended.

1). Non- IgA Mesangial Proliferative Glomerulonephritis

Both IgA Nephropathy and Non- IgA Mesangial Proliferative Glomerulonephritis can exhibit a clinical manifestation of hematuria, so a kidney biopsy is required in differentiating these 2 diseases.

2). Henoch-Schonlein Purpura Nephritis

Henoch-Schonlein Purpura Nephritis is a secondary glomerulonephritis which can present the same finding of IgA Nephropathy, hematuria and IgA deposition in mesangial area. However, patients with Henoch-Schonlein Purpura Nephritis will have skin purpura, abdominal pain, arthralgia and other constitutional symptoms. All these symptoms can facilitate the differential diagnosis of IgA Nephropathy and Henoch-Schonlein Purpura Nephritis.

3). Acute Post-streptococcal Glomerulonephritis

Both Acute Post-streptococcal Glomerulonephritis and IgA Nephropathy may occur after an upper respiratory infection following by hematuria, proteinuria, edema and high blood pressure. But patients with IgA Nephropathy may exhibit hematuria in one to three days after infection accompanied by elevated level of serum IgA; patients with Acute Post-streptococcal Glomerulonephritis may have Acute Nephrotic Syndrome (hematuria, proteinuria, edema and Hypertension) in one to two weeks after infection, the level of serum complement will decrease.

by: Jo Parker

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