IgA Nephropathy and Henoch-Schönlein purpura : discussion and consequences of their likely common physiopathology

Marie-Julie Debuf (1), Elise Hennaut (2), Jean-Philippe Stalens (3) Published in the journal : April 2018 Category : Pediatrics

Summary :

Henoch-Schönlein purpura is a vasculitis characterized by IgA immune deposits in small vessels and involving the skin, digestive tract, renal glomeruli, and joints. IgA nephropathy is a glomerulonephritis that is characterized by mesangial deposits of IgA and is associated with episodes of hematuria and/or proteinuria mainly occurring after respiratory or gastrointestinal infections. Despite some differences regarding the typical age of onset and natural history, a growing number of clinical, histological, and biochemical evidence suggests that these diseases are different clinical expressions of the same pathophysiological process, which could have consequences on their management.

What is already known about the topic?

  1. A growing number of evidence supporting the common origin of IgA nephropathy and Henoch-Schönlein purpura can be found in the scientific literature.
  2. The formal diagnosis of IgA nephropathy is always based on a renal biopsy.
  3. Tonsillectomy as part of IgA nephropathy treatment remains debated.

What does this article bring up for us?

  1. The article addresses the likely common origin of these two pathologies.
  2. In certain cases, performing a renal biopsy for diagnostic purposes could possibly be avoided.
  3. Tonsillectomy may be indicated in some patients with repeated episodes of acute renal failure associated with macroscopic hematuria triggered by pharyngitis.

Key Words

IgA nephropathy, Henoch-Schönlein purpura, renal biopsy, tonsillectomy