IgA Vasculitis with Nephritis in Adults: Histological and Clinical Assessment
1
Division of Nephrology, Fudan University Huashan Hospital, Shanghai 200040, China
2
Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
3
Department of Nutrition, University of Alabama at Birmingham, Birmingham, AL 35294, USA
4
Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
5
Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
*
Author to whom correspondence should be addressed.
Academic Editors: Kent Doi and Radica Alicic
J. Clin. Med. 2021, 10(21), 4851; https://doi.org/10.3390/jcm10214851
Received: 2 September 2021
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Revised: 13 October 2021
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Accepted: 17 October 2021
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Published: 22 October 2021
(This article belongs to the Special Issue New Insights into the Pathogenesis and Therapies of IgA Nephropathy)
Patients with IgA vasculitis (IgAV), an immune complex-mediated disease, may exhibit kidney involvement—IgAV with nephritis (IgAVN). The kidney-biopsy histopathologic features of IgAVN are similar to those of IgA nephropathy, but little is known about histopathologic disease severity based on the interval between purpura onset and diagnostic kidney biopsy. We assessed kidney histopathology and clinical and laboratory data in a cohort of adult patients with IgAVN (n = 110). The cases were grouped based on the interval between the onset of purpura and kidney biopsy: Group 1 (G1, <1 month, n = 14), Group 2 (G2, 1–6 months, n = 58), and Group 3 (G3, >6 months, n = 38). Glomerular leukocytes were more common in G1 than in the other groups (p = 0.0008). The proportion of neutrophils among peripheral-blood leukocytes was the highest in the patients biopsied within a month after onset of purpura (G1: 71 ± 8%). In the patients with an interval >6 months, the neutrophil proportion was lower, 60%. Moreover, the glomerular mesangial proliferation score correlated with the serum total IgA concentration (p = 0.0056). In conclusion, IgAVN patients biopsied <1 month from purpura onset showed an elevated percentage of blood neutrophils and glomerular leukocytes, consistent with an acute-onset inflammatory reaction. In all IgAVN patients, the mesangial proliferation score correlated with the serum IgA level.
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Keywords:
IgA vasculitis; nephritis; kidney biopsy
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MDPI and ACS Style
Lai, L.; Liu, S.; Azrad, M.; Hall, S.; Hao, C.; Novak, J.; Julian, B.A.; Novak, L. IgA Vasculitis with Nephritis in Adults: Histological and Clinical Assessment. J. Clin. Med. 2021, 10, 4851. https://doi.org/10.3390/jcm10214851
AMA Style
Lai L, Liu S, Azrad M, Hall S, Hao C, Novak J, Julian BA, Novak L. IgA Vasculitis with Nephritis in Adults: Histological and Clinical Assessment. Journal of Clinical Medicine. 2021; 10(21):4851. https://doi.org/10.3390/jcm10214851
Chicago/Turabian StyleLai, Lingyun, Shaojun Liu, Maria Azrad, Stacy Hall, Chuanming Hao, Jan Novak, Bruce A. Julian, and Lea Novak. 2021. "IgA Vasculitis with Nephritis in Adults: Histological and Clinical Assessment" Journal of Clinical Medicine 10, no. 21: 4851. https://doi.org/10.3390/jcm10214851
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