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Abstract
This study was done to illustrate the frequency of IgAN in patients admitted to Alexandria University Hospitals by using renal biopsy.
The study included seventy four nephrological cases were seen in Alexandria university hospitals over more than 6 months duration. Data was available only on sixty five cases out of those seventy four. only fifty five cases were biopsied and the remaining ten cases were not biopsied due to different causes; one case escaped, one case refused to undergo kidney biopsy ,one case died before doing biopsy and the remaining seven patients the diagnosis was rather evident and no need to do a biopsy. Forty four cases were further examined by immunofluorescence microscopy and in selected cases immunohistochemistry.
They include 32 males and 23 females with age range from 13-67 yrs,weight from 45-120 Kg. only 9.1% had a family history of renal disease and 49.1% of patients had history of drugs including NSAIDs, antibiotic and /or immunosuppressive regimens for previous disease
By utilizing the light microscopy , Histopathological diagnosis include 8 groups which are mesangioproliferativeGN, lupus nephritis, amyloidosis, ESRD, FSGS, MPGN, Crescentic GN and miscellaneous.
We enrolled 4 new primary IgAN patients over period of 6 months, with an active current file of about 65 patients for a population of 4,187,509 inhabitants(national statistics office in 1/1/2008),which gave an incidence of 2 pmp
Percentage of IgA deposits of all non-lupus GNs from all biopsies was 18.2%.they were eight cases divided into four primary cases and four secondary to amyloidosis due to FMF in one case and hepatosplenic schistosomiasis in the three other cases .
Different biochemical and radiological parameters were done including measurement of serum creatinine, estimation of GFR, serum IgA, serumC3, IgA/C3ratio, ultrasound abdomen & pelvis, pathological examination including the assessment of different proliferating and fibrotic parameter, beside the routine investigations and history taking and clinical examination.
In comparison between the different clinical groups, we did not find any significant differences as regard serum IgA and serum IgA/C3 ratio. However, if compared as individual groups serum IgA was significantly higher in the Nephrotic group in comparison to the ARF group. We did find significant increase in the urinary protein excretion (gm/24hrs) in the Nephrotic group in comparison to each of the ARF and CKD groups However , we found increase of serum creatinine between each of ARF and CKD in comparison to the other groups which had a rather normal renal function. On the other hand, there was a statistical significant increase of blood urea in CKD group in comparison to the other groups.