Contents

SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences
IgA nephropathy
Other Resources UpToDate PubMed

IgA nephropathy

Contributors: Shea A. Nagle MPH, Christine Osborne MD, Catherine Moore MD, Abhijeet Waghray MD
Other Resources UpToDate PubMed

Synopsis

Immunoglobulin A (IgA) nephropathy develops secondary to mesangial deposition of IgA and is a common primary cause of glomerulonephritis. Peak age of presentation is in the second and third decade, although patients may present at any age. The disease is more common in males than in females, with the greatest frequency in individuals of Northern European or Asian descent. There is also an increased risk of IgA nephropathy in patients with celiac disease.

Patients may present in any of the following ways:
  • Recurrent hematuria following viral pharyngeal or gastrointestinal tract infections
  • Asymptomatic detection of hematuria and proteinuria on routine screening
  • Rapidly progressive disease with associated edema, hypertension, hematuria, and renal insufficiency
In children, it may present with IgA vasculitis (formerly Henoch-Schönlein purpura) after a viral infection.

Codes

ICD10CM:
N02.8 – IgA nephropathy

SNOMEDCT:
236407003 – Immunoglobulin A nephropathy

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Acute poststreptococcal glomerulonephritis – Would usually be associated with history of group A streptococcal infection rather than viral infection.
  • Staphylococcus-associated Glomerulonephritis – Would usually be associated with staphylococcus infection rather than viral infection.
  • Thin basement membrane nephropathy – Usually associated with family history.
  • C3 glomerulopathy – Associated with elevated C3 levels.
  • Hemolytic uremic syndrome – Often presents with bacterial gastrointestinal tract infection and diarrhea.
  • Alport syndrome – Presents with hematuria, sensorineural hearing loss, vision problems, and family history.
  • Goodpasture disease (Antiglomerular basement membrane disease) – Presents with hemoptysis.
  • Granulomatosis with polyangiitis (Wegener granulomatosis) – Presents with chronic sinusitis and cough, c-ANCA associated, patients in remission may develop IgA nephropathy.
  • Microscopic polyangiitis – Presents with purpura and cough, p-ANCA associated.
  • Eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome) – Presents with asthma and sinusitis, p-ANCA associated.
  • Membranoproliferative glomerulonephritis – Associated with hepatitis B, hepatitis C, or low levels of C3.
  • Systemic lupus erythematosus nephritis

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:01/07/2019
Last Updated:12/06/2021
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IgA nephropathy
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A medical illustration showing key findings of IgA nephropathy : Dark urine, Flank pain, Oliguria, Proteinuria, RBC casts, Recurring episodes or relapses, Gross hematuria
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