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Clinical characteristics of concomitant nephrotic IgA nephropathy and minimal change disease in children

Huijun Shen1, Weizhong Gu, Jianhua Mao

  • 1Department of Nephrology, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China.

Nephron
|May 1, 2015
PubMed

Insights

IgA nephropathy (IgAN) can coexist with minimal change disease (MCD) in children. Most pediatric patients with this IgAN and MCD overlap, presenting with nephrotic syndrome, respond well to steroid treatment and show a favorable prognosis.

Area of Science:

  • Pediatric Nephrology
  • Glomerular Diseases
  • Renal Pathology

Background:

  • IgA nephropathy (IgAN) is the most common primary glomerulonephritis in children.
  • Minimal change disease (MCD) is the leading cause of nephrotic syndrome in pediatric populations.
  • Coexistence of IgAN and MCD has been reported in adults, but pediatric data are limited.

Purpose of the Study:

  • To investigate the clinical and pathological features of IgA nephropathy (IgAN) complicated by minimal change disease (MCD) in children.
  • To evaluate the treatment response and prognosis of pediatric patients with coexisting IgAN and MCD.

Main Methods:

  • Retrospective analysis of 197 children diagnosed with IgAN between December 2007 and November 2013.
  • Evaluation based on nephrotic syndrome criteria and MCD pathological features.
  • Assessment of clinical manifestations, treatment, and follow-up data.

Main Results:

  • Seven out of 197 (2.8%) IgAN patients presented with both MCD-like pathology and nephrotic syndrome.
  • The affected cohort included 5 boys with a median age of 8.9 years.
  • Six of the seven patients showed steroid sensitivity and achieved complete remission, indicating a favorable prognosis.

Conclusions:

  • IgA nephropathy (IgAN) and minimal change disease (MCD) can occur concurrently in pediatric patients.
  • Children with coexisting IgAN and MCD presenting with nephrotic syndrome generally respond well to corticosteroid therapy.
  • Further large-scale studies are warranted to understand these complex cases better.
Abstract

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