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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2005 December;164(6):465-71
Pathological spectrum of primary immunoglobulin. A nephropathy in western India
Vanikar A. V. 1, Trivedi H. L. 2, Kanodia K. V. 1, Patel R. D. 1, Shah P. R. 2
1 Department of Pathology, Laboratory Medicine and Transfusion Services and Department of Immunohematology, Civil Hospital Campus, Asarwa, Ahmedabad, India;
2 Department of Nephrology and Transplantation Medicine, Civil Hospital Campus, Asarwa, Ahmedabad, India
Aim. Although primary IgA nephropathy (IgAN) is a common glomerulonephritis, there are rare documented studies of its evolution in India. This 7 year retrospective study aims at finding out its incidence and natural history in western India.
Methods. We studied 5542 native renal biopsies, using hematoxylin and eosin, periodic acid Schiff, Jone’s silver methaneamine and Gomori’s trichrome stains on 3 μm paraffin sections. Immunofluorescence studies were performed using anti-human IgA, IgG, IgM, C1q, C3, albumin and fibrinogen antisera. Patients with hematuric nephrotic/nephritic presentation were selected, their biopsies studied and those with predominant/codominant IgA deposits were labeled as primary IgAN. We studied their morphological pattern (classified as per IgAN databank), clinical, lab parameters and correlated them.
Results. Incidence of primary IgAN in patients with nephrotic/nephritic syndrome is 16.5 % in western India; more common in young males in second/third decade of life, pure mesangiopathy being the commonest pattern, C3 and IgG were common co-deposits. Patients with combined lesions had more frequent relapsing episodes of hematuria. Nephritic syndrome was more common presentation and older patients had more aggressive disease with vicious injury.
Conclusion. Primary IgAN is a neglected disease in India, this study may direct towards new efforts in clinical research for its treatment.