IgA nephropathy: Difference between revisions
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*[[Hematuria]], persistent or recurrent, macroscopic or asymptomatic microscopic | *[[Hematuria]], persistent or recurrent, macroscopic or asymptomatic microscopic | ||
**Gross hematuria initially begins a few days after febrile illness, thus mimicking acute postinfectious glomerulonephritis | **Gross hematuria initially begins a few days after febrile illness, thus mimicking acute postinfectious glomerulonephritis | ||
*Mild proteinuria | *Mild [[proteinuria]] | ||
*+/- [[flank pain]], [[fever]] during acute episodes | *+/- [[flank pain]], [[fever]] during acute episodes | ||
*Usually slowly progressive, but rapidly progressive glomerulonephritis manifests initially in <10% of patients | *Usually slowly progressive, but rapidly progressive glomerulonephritis manifests initially in <10% of patients | ||
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==Evaluation== | ==Evaluation== | ||
*[[UA]] | *[[UA]] | ||
**Hematuria, usually with dysmorphic RBCs, occasional RBC casts | **[[Hematuria]], usually with dysmorphic RBCs, occasional RBC casts | ||
**Mild proteinuria | **Mild [[proteinuria]] | ||
*BMP | *BMP | ||
**Creatinine usually normal unless progressed | **Creatinine usually normal unless progressed | ||
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==Disposition== | ==Disposition== | ||
Discharge | *Discharge | ||
==See Also== | ==See Also== | ||
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==References== | ==References== | ||
https://www.merckmanuals.com/professional/genitourinary-disorders/glomerular-disorders/immunoglobulin-a-nephropathy | |||
<references/> | <references/> | ||
[[Category:Renal]] | [[Category:Renal]] | ||
Latest revision as of 17:52, 16 October 2019
Background
- Nephritic syndrome, form of chronic glomerulonephritis caused by deposition of IgA immune complexes in glomeruli
- Slowly progressive
Clinical Features
- Hematuria, persistent or recurrent, macroscopic or asymptomatic microscopic
- Gross hematuria initially begins a few days after febrile illness, thus mimicking acute postinfectious glomerulonephritis
- Mild proteinuria
- +/- flank pain, fever during acute episodes
- Usually slowly progressive, but rapidly progressive glomerulonephritis manifests initially in <10% of patients
Differential Diagnosis
Hematuria
- Pediatric patients
- Glomerulonephritis
- UTI
- Congenital urinary tract anomaly
- Younger adults
- Older adults
- Any age
- Schistosomiasis (most common cause worldwide)
Evaluation
- UA
- Hematuria, usually with dysmorphic RBCs, occasional RBC casts
- Mild proteinuria
- BMP
- Creatinine usually normal unless progressed
- Definitive diagnosis with renal biopsy
Management
- Usually no treatment required in ED
- ACEi or ARB for hypertension, Cr >1.2, or macroalbuminuria
- Corticosteroids and/or cyclophosphamide for advanced or rapidly progressive disease
Disposition
- Discharge