Paramesangial destructive lesions in immunoglobulin A nephritis

Paramesangial lesions leading to segmental extracapillary damage were observed in the glomeruli of immunoglobulin A nephritis. Subepithelial accumulation of proteinaceous materials from the mesangium could result in the degeneration and exfoliation of podocytes, apparently with subsequent formation of segmental extracapillary lesions or adhesion to Bowman's capsule (or both). Paramesangial destructive lesions may be initiated by the overloading of the mesangial pathway in glomerular inflammation.