Decent Essays
Signs and symptoms:
Haematuria, microscopic and macroscopic, is the earliest sign and is almost universal.In case of microscopic the disease may remain unnoticed for decades. Hypertension is also very common. Proteinuria can also occur but is usually a later feature. In many cases, there is slowly progressive loss of renal function leading to end stage renal disease. Clinical presentations are protean and vary with age. A particular hallmark of IgA nephropathy in young adults is the occurrence of acute self-limiting exacerbations, often with gross haematuria, in association with minor respiratory infections. This may be so acute as to resemble acute post-infectious glomerulonephritis, with fluid retention, hypertension and oliguria with dark or red urine. Characteristically, the latency from clinical infection to nephritis is short: a few days or less. Asymptomatic presentations dominate in older adults, with haematuria, hypertension and loss of GFR. Occasionally, IgA nephropathy
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Asymptomatic hematuria with minimal proteinuria (i.e., 3 g/d) is not uncommon in IgAN, coexistence of the nephrotic syndrome is rare(59). A rare clinical presentation more in keeping with dual diagnoses of IgAN and minimal change disease is also well described. Renal function is often preserved, and overt nephrotic syndrome with edema, dyslipidemia, and hypoalbuminemia is present. Steroid responsiveness and favorable prognosis is often associated to minimal change lesions(60), although a steroid-sparing agent is often required to maintain remission. Finally IgAN with rapidly progressive course is rare and most frequently associated with a pathologic finding of >50% of glomeruli characterized by exhibiting crescentic deposits . The largest case series of 113 subjects described a rate of end stage renal disease of 42.5% at 1 year despite
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