IgA nephropathy: Difference between revisions
ClaireLewis (talk | contribs) (Created page with "==Background== *Nephritic syndrome, form of chronic glomerulonephritis caused by deposition of IgA immune complexes in glomeruli *Slowly progressive ==Clinical Features==...") |
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*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 | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 22:11, 25 August 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