Rapports de cas cliniques et médicaux

The Youngest Paediatric Presentation of IgA Nephropathy

Abstract

Kibriya Fidan*, Neil J Sebire and Stephen D Marks

Objectives: To describe the clinical course and three year follow-up of the youngest case of IgA nephropathy (IgAN).
Method: Retrospective case note review.
Result: A 26 month old girl presented with after intermittent macroscopic haematuria, nephrotic syndrome without hypertension or renal dysfunction. She had 3+ proteinuria and 3+ of haematuria on urinary dipstick testing. Her urine showed >500 × 106/L red without white cells or growth on culture and albumin: creatinine ratio of 253 mg/mmol without hypercalciuria. She was hypoalbuminaemic at 25 g/L. Her ASO titre and complements were normal with elevated IgA of 1.57 g/L. Her renal biopsy demonstrated IgA nephropathy (IgAN) with diffuse global mesangial proliferative glomerulonephritis with associated diffuse strong granular mesangial IgA deposition. She was commenced on an ACEI together with fÃ?â??Ã?±sh-oil supplements. She had evidence of hyperfiltration without proteinuria, macroscopic haematuria or hypertension at follow-up of three years.
Conclusion: This is the youngest published case of IgA nephropathy. Detecting IgA nephropathy early may offer the possibility of treatment to prevent progression of the disease.