Garland-pattern postinfectious glomerulonephritis with IgA-dominant deposition

A histological subtype of acute postinfectious glomerulonephritis (APIGN), the garland pattern, is identified not only by characteristic histological findings, but also by severe clinical course as compared with typical APIGN. However, since the morbidity of APIGN has decreased globally, there have been few reports on this disease form in developed countries during the last two decades. Herein, we report a case of adolescent garland-pattern APIGN with IgA-dominant deposits, presenting with severe nephrotic syndrome and protracted hematuria and proteinuria. We also review the clinical and histological features of 13 previously reported cases in Japan and compare them with our present case. In our review, we confirmed IgA deposition in at least three of these patients, in whom urinary protein excretion tended to be greater than those patients without IgA. Greater awareness of this condition is necessary to ensure appropriate follow-up of the clinical course of patients with garland-pattern APIGN with IgA deposition.