Pathogenesis (disease development) Immunoglobulin A (IgA) nephropathy is the most common cause of adult idiopathic glomerulonephritis. The pathogenesis of mesangial IgA glomerulonephritis has not been fully elucidated. IgA immune complexes are thought to be deposited in the glomerular mesangium, where they maintain an inflammatory response. This leads to scarring, which in turn can lead to … Mesangial IgA Glomerulonephritis: Causes
General measures Nicotine restriction (refraining from tobacco use). Review of permanent medication due topossible effect on the existing disease. Vaccinations The following vaccinations are advised, as infection can often lead to worsening of the present disease: Flu vaccination Hepatitis B vaccination Pneumococcal vaccination Regular checkups Regular medical checkups Nutritional medicine Nutritional counseling based on nutritional … Glomerulonephritis, IgAGN: Therapy
An at-risk group indicates the possibility that the disease may be associated with the risk of vital nutrient (micronutrient) deficiency. The complaint nephrotic syndrome indicates vital nutrient (micronutrient) deficiency for: Calcium Iron Copper Zinc A risk group indicates the possibility that the disease may be associated with the risk of vital substance deficiency (micronutrients). The … Mesangial IgA Glomerulonephritis: Micronutrient Therapy
The following symptoms and complaints may indicate mesangial IgA glomerulonephritis: Leading symptoms Microhematuria (microscopically visible blood in the urine) (asymptomatic microhematuria in 40-80% of patients). Recurrent macrohematuria (blood in urine visible to the naked eye) – 2-3 days after upper respiratory tract infection (30-70% of patients) Low proteinuria (excretion of protein in urine: < 1.5 … Mesangial IgA Glomerulonephritis: Symptoms, Complaints, Signs
Blood, hematopoietic organs-immune system (D50-D90). Schönlein-Henoch purpura (age <20 years). Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99). Other forms of glomerulonephritis Benign familial hematuria (synonym: thin basement membrane nephropathy) – isolated, familial persistent glomerular hematuria (blood in the urine) and minimal proteinuria (protein in the urine) with normal renal function.
The following are the major diseases or complications that may be co-morbid with mesangial IgA glomerulonephritis: Genitourinary system (kidneys, urinary tract-genital organs) (N00-N99). Acute renal failure (5% of cases). Nephrotic syndrome – collective term for symptoms that occur in various diseases of the glomerulus (renal corpuscles); the symptoms are proteinuria (increased excretion of protein in … Mesangial IgA Glomerulonephritis: Complications
MEST (Oxford) classification of IgA nephropathy (IgAN). The Oxford classification of IgA nephropathy is based on four histologic (“fine tissue”) parameters (MEST) to be evaluated biopsy. For evaluation, at least 8 glomuerula (singular: Glomerulus; vascular loops located in the renal cortex and inverted into Bowman’s capsule) must be present in the biopsy (tissue sample). Mesangial … Mesangial IgA Glomerulonephritis: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye) [accompanying symptom: edema (water retention)]. Auscultation (listening) of the heart [due topossible cause: endocarditis (meningitis)] Auscultation of the lungs … Mesangial IgA Glomerulonephritis: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood), sediment, urine culture if necessary (pathogen detection and resistogram, i.e. testing suitable antibiotics for sensitivity/resistance). Erythrocyte morphology (shape of the erythrocytes / red blood cells) by phase contrast microscopy [dysmorphic … Mesangial IgA Glomerulonephritis: Test and Diagnosis
Therapeutic target Avert deterioration of renal function Therapy recommendations Stepwise therapy as follows: Proteinuria (increased excretion of protein in urine) > 1 g/d and normal renal function: ramipril (RAAS blockade with ACE inhibitors; result in decreased protein excretion/protein excretion and prevent disease progression (nephroprotection)). Proteinuria > 1 g/d and concomitant renal insufficiency (kidney weakness): therapy … Mesangial IgA Glomerulonephritis: Drug Therapy
Obligatory medical device diagnostics. Renal sonography (ultrasonography of the kidneys). Kidney biopsy (tissue sampling from the kidney) – for definitive diagnosis, treatment planning, prognosis assessment.
Medical history (history of illness) represents an important component in the diagnosis of mesangial IgA glomerulonephritis. Family history Is there a history of frequent kidney disease in your family? Social history Current medical history/systemic history (somatic and psychological complaints). Have you noticed water retention on your body? Have you noticed any changes in your urine? … Mesangial IgA Glomerulonephritis: Medical History
