Re: IgAN in preschool-age children

[Guest guest]

Pierre, can you please explain this to me!

Pierre wrote: Here's another article from my archives.

This one dates back to 2000. Should

be reassuring to parents of young children with IgAN.

--Pierre

Features of IgA nephropathy in preschool children

Y. Utsunomiya1, T. Kado1, T. Koda1, S. Okada1, A. Hayashi1,

A. Fukawaza1, T. Nakagawa1, S. Kanzaki1 and T. Kasagi2

1Department of Pediatrics and 2Department of Health Care Technology,

Faculty of Medicine, Tottori University, Yonago, Japan

Aim: The aim of this study is to clarify the age-related characteristics of

pediatric IgA nephropathy. Patients and methods: Five cases in preschool

children less than 6 years old were analyzed and compared to 38 cases in

older children from 6 to 15 years old. Results: The group of younger

children had higher incidences of gross hematuria, hypertension,

proteinuria, and hypoproteinemia. Renal biopsy specimens in this group

showed more intracapillary lesions including mesangial cell proliferation

and endocapillary proliferation of glomeruli, but less segmental lesions,

global sclerosis, and interstitial changes. Conclusion: IgA nephritis in

preschool children demonstrated more symptoms of acute onset and less

chronic renal injury.

[Guest guest]

You guys ask tough questions : )

I'm going to have to go to medical school and become a renal pathologist one

of these days in order to keep up.

Here's my best shot:

They found in their study that younger children with IgAN tend to have more

occurence of visible blood in their urine, more protein in the urine (along

with lower protein levels in the blood - which isn't good), and more high

blood pressure, than older children. I would say that this seems to be

consistent with what parents have reported on this group over the years.

But, on the positive side, despite this, they do better in the long run.

They tend to suddenly get into an acute situation, but this acute nephritis

(inflammation of the glomeruli) seems to resolve itself without too much

permanent damage.

The other stuff they mention are renal pathology features they see in biopsy

specimens. This can get pretty complicated, and I'm certainly not even close

to knowing much about that, but, basically, it means they found lesions in

and around the capillaries, which are the tiny looped blood vessels that a

glomerulus is made of (the actual main part of the filter units in the

kidneys). Mesangial proliferation means expansion of the space around the

glomeruli which is called the mesangium. This is where IgA proteins are

deposited and cause IgA nephropathy. Endocapillary proliferation means

increase of cells in cells is within the glomerular tuft (this is worse than

the mesangial proliferation itself). However, there are fewer isolated

lesions in segments of the glomeruli, fewer lesions that are generalised all

over the glomeruli, and fewer changes in the interstitial spaces between the

glomeruli. So that's good, probably why there is less permanent or chronic

damage in there as a result.

I hope that answers your question. Keep in mind that any one study isn't all

that significant on its own though.

Pierre

Re: IgAN in preschool-age children

>

> Pierre, can you please explain this to me!

> Pierre wrote: Here's another article from my

archives. This one dates back to 2000. Should

> be reassuring to parents of young children with IgAN.

> --Pierre

>

> Features of IgA nephropathy in preschool children

> Y. Utsunomiya1, T. Kado1, T. Koda1, S. Okada1, A. Hayashi1,

> A. Fukawaza1, T. Nakagawa1, S. Kanzaki1 and T. Kasagi2

>

> 1Department of Pediatrics and 2Department of Health Care Technology,

> Faculty of Medicine, Tottori University, Yonago, Japan

>

> Aim: The aim of this study is to clarify the age-related characteristics

of

> pediatric IgA nephropathy. Patients and methods: Five cases in preschool

> children less than 6 years old were analyzed and compared to 38 cases in

> older children from 6 to 15 years old. Results: The group of younger

> children had higher incidences of gross hematuria, hypertension,

> proteinuria, and hypoproteinemia. Renal biopsy specimens in this group

> showed more intracapillary lesions including mesangial cell proliferation

> and endocapillary proliferation of glomeruli, but less segmental lesions,

> global sclerosis, and interstitial changes. Conclusion: IgA nephritis in

> preschool children demonstrated more symptoms of acute onset and less

> chronic renal injury.

>

>

>

>