Skip to main content
SpringerLink
Log in

IgA nephropathy presenting clinicopathological features of acute post-streptococcal glomerulonephritis

  • Nephrology/Urology
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Abstract

A 5-year-old Japanese girl was affected with acute nephritis. The patient had hypo-complementaemia and an elevation of anti-streptolysin O with positive throat culture of Group A streptococci. Four weeks after onset of the disease, serum complement level returned to normal, but proteinuria increased into the nephrotic range with a deterioration in renal function. Four weeks after onset, light microscopy of a renal biopsy showed diffuse endocapillary proliferation, and immunofluoroscopy revealed predominant IgA deposition in the mesangium. Electron microscopy showed electron dense deposits in the mesangial and subendothelial area, but subepithelial deposits were not found in the glomeruli. Histological diagnosis was IgA nephropathy, while her clinico-serological features were typical of acute post-streptococcal glomerulonephritis

Conclusion

These results suggest that in some patients, IgA nephropathy may be triggered by streptococcal infection and misdiagnosed as acute post-streptococcal glomerulonephritis if renal histological examinations are not done.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

APSGN :

acute post-streptococcal glomerulonephritis

ASLO :

anti-streptolysin O antibody

ASK :

anti-streptokinase antibody

EDD :

electron dense deposit

ADNAse B :

anti-DNAse B antibody

References

  1. Berger J (1969) IgA glomerular deposits in renal disease. Transplant Proc 1: 939–944

    PubMed  Google Scholar 

  2. Cairns SA, London A, Mallick NP (1981) Circulating immune complexes following food: delayed clearence in idiopathic glomerulonephritis. J Clin Lab Immunol 6: 121–126

    PubMed  Google Scholar 

  3. Clarkson AR, Seymour AE, Thompson AJ, Haynes WDG, Chan YL, Jackson B (1977) IgA nephropathy: a syndrome of uniform morphology, diverse clinical features and uncertain prognosis. Clin Nephrol 8: 459–471

    PubMed  Google Scholar 

  4. Coppo R, Basolo B, Rollino C, Roccatello D, Martin G, Amore A, Bogiorno G, Piccoli G (1986) Mediterranean diet and primary IgA nephropathy. Clin Nephrol 26: 72–82

    PubMed  Google Scholar 

  5. Gregory MC, Hammond ME, Brewer ED (1988) Renal deposition of cytomegalovirus antigen in immunoglobulin-A nephropathy. Lancet 1: 11–14

    PubMed  Google Scholar 

  6. Heptinstall RH (1983) Pathology of the kidney, 3rd edn. Little, Brown and Company Boston, pp 387–442

    Google Scholar 

  7. Herdson PB, Jennings RB, Earle DP (1966) Glomerular fine structure in poststreptococcal acute glomerulonephritis. Arch Pathol 81: 117–128

    PubMed  Google Scholar 

  8. Kimmelstiel P, Kim OJ, Beres J (1962) Studies on renal biopsy specimens with the aid of the electron microscope: II. Glomerulonephritis and glomerulonephrosis. Am J Clin Pathol 38: 280–296

    PubMed  Google Scholar 

  9. Nagy J, Uj M, Szucs G, Trinn C, Berger T (1984) Herpes virus antigens and antibodies in kidney biopsies and sera of IgA glomerulonephritic patients. Clin Nephrol 21: 259–262

    PubMed  Google Scholar 

  10. Okada K, Funai M, Kawakami K, Kagami S, Yano I, Kuroda Y (1990) IgA nephropathy in Japanese children and adults: a comparative study of clinicopathological features. Am J Nephrol 10: 191–197

    PubMed  Google Scholar 

  11. Rekola S, Bergstrand A, Bucht H, Lindberg A (1994) Are beta-haemolytic streptococci involved in the pathogenesis of mesangial IgA-nephropathy? Proc Eur Dial Transplant Assoc Eur Ren Assoc 21: 698–702

    Google Scholar 

  12. Sancho J, Egido J, Rivera F, Hernando L (1983) Immune complexes in IgA nephropathy: presence of antibodies against diet antigens and delayed clearance of specific polymeric IgA immune complexes. Clin Exp Immunol 54: 194–202

    PubMed  Google Scholar 

  13. Sinniah R, Javier AR, Ku G (1981) The pathology of mesangial IgA nephritis with clinical correlation. Histopathology 5: 469–490

    PubMed  Google Scholar 

  14. Tomino Y, Endoh M, Nomoto Y, Sakai H (1982) Specificity of eluted antibody from renal tissues of patients with IgA nephropathy. Am J Kidney Dis 1: 276–280

    PubMed  Google Scholar 

  15. Tomino Y, Sakai H, Endoh M, Suga T, Miura M, Kaneshige H, Nomoto Y (1983) Cross reactivity of IgA antibodies between renal mesangial areas and nuclei of tonsillar cells in patients with IgA nephropathy. Clin Exp Immunol 51: 605–610

    PubMed  Google Scholar 

  16. Tomino Y, Sakai H, Hashimoto K, Tanaka S (1987) Antigenic heterogeneity in patients with IgA nephropathy. Semin Nephrol 7: 294–296

    PubMed  Google Scholar 

  17. Törnroth T (1976) The fate of subepithelial deposits in acute poststreptococcal glomerulonephritis. Lab Invest 35: 461–474

    PubMed  Google Scholar 

  18. Van der Woude FJ, Hoedemaeker PJ, Giessen M van der, Graeff PA de, Monchy J de, The TH, Hem GK van der (1983) Do food antigens play a role in the pathogenesis of some cases of human glomerulonehpritis? Clin Exp Immunol 51: 587–594

    PubMed  Google Scholar 

  19. Woodroffe AJ, Gormly AA, Mckenzie PE, Wootton AM, Thompson AJ, Seymour AE, Clarkson AR (1980) Immunologic studies in IgA nephropathy. Kidney Int 18: 366–374

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Paediatrics, University of Tokushima, Kuramoto-cho 3-chome, 770, Tokushima, Japan

    Kaname Okada, Rui Jin Zhang, Takashi Kuhara, Koji Yasutomo & Yasuhiro Kuroda

  2. Department of Paediatrics, Ohkawa General Hospital, Sangawa-cho, Ohkawa-gun, 769-23, Kagawa, Japan

    Shin-ichi Saitoh & Zen-ichi Sakaguchi

Authors
  1. Kaname Okada
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shin-ichi Saitoh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zen-ichi Sakaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rui Jin Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takashi Kuhara
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Koji Yasutomo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yasuhiro Kuroda
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Okada, K., Saitoh, Si., Sakaguchi, Zi. et al. IgA nephropathy presenting clinicopathological features of acute post-streptococcal glomerulonephritis. Eur J Pediatr 155, 327–330 (1996). https://doi.org/10.1007/BF02002722

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02002722

Key words

Search

Navigation