课件：IgA肾病结合内科.ppt

IgA 肾病 IgA nephropathy Hebei medical university Xu qingyou definition IgA nephropathy is the most common glomerulonephritis throughout the world. Primary IgA nephropathy is characterized by deposition of the IgA antibody in the glomerulus. definition IgA nephropathy remains the one of the most common, if not the most common, glomerular lesions of all the forms of glomerulonephritis. IgA nephropathy (also known as IgA nephritis, IgAN, Bergers disease) is a form of glomerulonephritis (inflammation of the glomeruli of the kidney). definition IgA nephropathy was initially described in the late 1960s by Berger and Hinglais, and patients were described on the basis of the finding of predominant IgA deposition(and ,to a lesser extent, other immunoglobulins) in the mesangium with a mesangial proliferation, and with clinical features that span the spectrum from asymptomatic hematuria to repidly progressive glomerulonephritis. Berger J,Hinglais N. J Urol Nephrol 1968, 74: 694 definition The distribution of IgA nephropathy varies in the different geographic regions throughout the world. It was the most common form of primary glomerular disease in Asia, evident in up to 30% to 40% of all biopsies, 20% in Europe, and 10% of all biopies performed for glomerular disease in North America. 30% to 40% 10% 20% Signs and symptoms The classic presentation (in 40-50% of the cases) is episodic frank hematuria which usually starts within a day or two of a non-specific upper respiratory tract infection (hence synpharyngitic) as opposed to post-streptococcal glomerulonephritis which occurs some time (weeks) after initial infection. Less commonly gastrointestinal or urinary infection can be the inciting agent. All of these infections have in common the activation of mucosal defenses and hence IgA antibody production. Loin pain can also occur. The gross hematuria resolves after a few days, though microscopic hematuria may persist. These episodes occu