IgA Nephropathy (Berger's Disease): Causes and Prognosis

IgA Nephropathy (IgAN), also known as Berger's disease and synpharyngitic glomerulonephritis) is a special form of glomerulonephritis, and occurs more commonly in young adults. Usually, there will be infections of upper respiratory tracts before the first onset. The features of pathological changes include hyperplasia of mesangium and large amount of immune complex deposited in mesangium, which could be seen as IgA deposit in visible mensangial cells by immunofluorescence test.

Pathological Changes

Pathological changes differ variously in extent. Earlier pathological changes are slight, presenting focal changes, and only small amount of glomerulus have mild widening and proliferations in stages. Focal and proliferatie lesions would progress to focal sclerosis. Some lesions are quite obvious with diffuse mesangial proliferations, or crescents occasionally. The most distinguishing features are IgA deposit in visible mesangial cells by immunofluorescence test
IgA Nephropathy is Chronic Glomerulus Disease with same immunopathological characters caused by multiple aetiologies. In clinical practice, 40% to 45% of the patients have gross urine or microscopic hematuria; 35% to 40% of the patients have microscopic hemtauria and albuminuria; the rest have nephrotic syndrome and kidney failure.

Relevant Factors Effecting the Prognosis of IgA Nephropathy:

(1) Male patients have poor prognosis with elderly onset.
(2) Poor prognosis with persistent microscopic hemtauria and albuminuria.
(3) Poor prognosis with moderate or severe albuminuria which would progress to renal dysfunction. But IgA Nephropathy patients with symptoms of nephrotic syndrome have better prognosis, if they have good response to glucocorticoid treatment and mild pathological lesions in the renal tissues.
(4) Poor prognosis if the patients have hypertension, especially for those who have severe hypertension hard to control.
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