Relation between biological IgA abnormalities and mesangial IgA deposits in isolated hematuria in childhood. 1987

J C Davin, and J B Foidart, and P R Mahieu
Department of Pediatrics, State University of Liege, Hôpital de Bavière, Belgium.

Indications for renal biopsies in isolated hematuria in childhood remain difficult to define. Their limitation to patients presenting with either a macroscopic or a familial hematuria [Trachtman et al. 1984] bears the potential risk of missing the diagnosis of IgA-associated nephropathies (Berger disease and Henoch-Schönlein nephritis) which may manifest themselves by microscopic hematuria only. In order to reevaluate the association between biological IgA abnormalities and mesangial IgA deposits, iterative and concomitant determinations of IgA plasma levels, of IgA immune complexes and of IgA production by lymphocytes in vitro have been performed over a one-year period in two groups of hematuric children presenting with mesangial IgA deposits (14 cases) or not (13 cases). The incidence of positivity of each test was significantly higher in the former group of patients than in the latter. However, the best discrimination between both groups was observed when the three tests were repeated and/or considered together (97% vs 15% of positivity). In Berger disease and Henoch-Schönlein nephritis, IgA immune complexes were the only IgA abnormality more frequently detected in patients presenting with hematuria than in patients presenting with no hematuria at the time of testing. It is proposed to add IgA abnormalities to macroscopic or familial hematuria as indications for renal biopsies in isolated hematuria in childhood.

UI MeSH Term Description Entries
D007070 Immunoglobulin A Represents 15-20% of the human serum immunoglobulins, mostly as the 4-chain polymer in humans or dimer in other mammals. Secretory IgA (IMMUNOGLOBULIN A, SECRETORY) is the main immunoglobulin in secretions. IgA,IgA Antibody,IgA1,IgA2,Antibody, IgA
D007158 Immunologic Techniques Techniques used to demonstrate or measure an immune response, and to identify or measure antigens using antibodies. Antibody Dissociation,Immunologic Technic,Immunologic Technics,Immunologic Technique,Immunological Technics,Immunological Techniques,Technic, Immunologic,Technics, Immunologic,Technique, Immunologic,Techniques, Immunologic,Antibody Dissociations,Dissociation, Antibody,Dissociations, Antibody,Immunological Technic,Immunological Technique,Technic, Immunological,Technics, Immunological,Technique, Immunological,Techniques, Immunological
D008214 Lymphocytes White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each), or NATURAL KILLER CELLS. Lymphoid Cells,Cell, Lymphoid,Cells, Lymphoid,Lymphocyte,Lymphoid Cell
D008297 Male Males
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005260 Female Females
D005920 Glomerular Mesangium The thin membranous structure supporting the adjoining glomerular capillaries. It is composed of GLOMERULAR MESANGIAL CELLS and their EXTRACELLULAR MATRIX. Mesangium, Glomerular,Mesangial Extracellular Matrix,Extracellular Matrices, Mesangial,Extracellular Matrix, Mesangial,Glomerular Mesangiums,Matrices, Mesangial Extracellular,Matrix, Mesangial Extracellular,Mesangial Extracellular Matrices,Mesangiums, Glomerular
D005922 Glomerulonephritis, IGA A chronic form of glomerulonephritis characterized by deposits of predominantly IMMUNOGLOBULIN A in the mesangial area (GLOMERULAR MESANGIUM). Deposits of COMPLEMENT C3 and IMMUNOGLOBULIN G are also often found. Clinical features may progress from asymptomatic HEMATURIA to END-STAGE KIDNEY DISEASE. Berger Disease,Immunoglobulin A Nephropathy,Nephropathy, IGA,Berger's Disease,IGA Glomerulonephritis,IGA Nephropathy,Iga Nephropathy 1,Nephritis, IGA Type,Bergers Disease,Glomerulonephritides, IGA,IGA Type Nephritis,Nephropathy 1, Iga,Nephropathy, Immunoglobulin A
D006417 Hematuria Presence of blood in the urine. Hematurias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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