Study of tonsillectomy for IgA nephropathy patients: short- and longer-term observation

We observed serum parameters and urinary findings of IgA nephropathy (IgAN) patients in the short and longer time after tonsillectomy, to provide evidences to clarify the role of tonsils in the pathogenesis of IgAN and the feasibility of tonsillectomy for IgAN patients.

For the short-term study, 19 patients with both IgAN and chronic tonsillitis (group A) and 19 patients with chronic tonsillitis (group B) were performed bilateral tonsillectomy and 19 healthy people as normal controls (group C). Another 115 patients with IgAN and chronic tonsillitis including 61 patients for tonsillectomy combined with drug therapy and 54 for drug therapy alone followed up for 12 months.

Fourteen patients of group A showed a deterioration of urinary findings, while only 2 patients of group B showed deterioration (P < 0.01). Both serum IgA and IgA1 levels were significantly higher in group A than that in group B or group C (P < 0.05, respectively). Levels of serum IgA and IgA1 of group A increased after tonsillectomy and did not increase instantly, but increased at day 3, then decreased at day 5. Both serum IgA and IgA1 levels were positively related to urinary red blood cell count (P < 0.01, r s = 0.362, r s = 0.347, respectively). For longer-term study, urinary findings of IgAN patients underwent tonsillectomy were improved significantly than that of patients without tonsillectomy (P < 0.05).

Tonsils play an important role in the development of IgAN, and tonsillectomy may be a feasible treatment method for IgAN patients with chronic tonsillitis.