Clinicopathological correlation in forty-two children with IgA nephropathy

A retrospective study of 42 children with IgA nephropathy was undertaken to clarify possible correlations between clinical and histological features, severity and known prognostic factors. The disease was graded in both pathological (class I-V) and clinical (class A-D) classifications. There were no differences in clinical and laboratory data when compared with respect to gross hematuria, but the number of cases with proteinuria more than 150 mg/day is significantly greater in those with gross hematuria than with microhematuria (p less than 0.01). All of the patients with microhematuria were included in pathologic classes I and II. The patients with proteinuria less than 1 g/day is skewed to pathologic classes I and II, in contrast to the patients with more than 3 g/day, to pathologic class IV. Serum IgA level was increased only in 35.7% at the time of biopsy, most of which cases complained of gross hematuria. Immunofluorescence studies showed predominant deposits of IgA in the mesangium in all cases, while capillary deposits were found in 7 cases. Among the 12 cases of pathologic class IV, half of them had capillary IgA and fibrinogen deposits.