IgA nephropathy: Henoch-Schönlein purpura and Berger's disease in one patient

A patient is described who had an attack of Henoch-Schönlein purpura with no renal dysfunction at 4 years of age. She recovered with conservative management. There were no further episodes of Henoch-Schönlein purpura and her urinalysis remained normal for the next 11 years. At age 15, she developed repeated bouts of gross hematuria and proteinuria, and a renal biopsy was performed 3 years later. Light microscopy showed mesangial proliferative glomerulonephritis with granular, mesangial deposits of IgA by immunofluorescence and numerous, electron-dense deposits in mesangial regions by electron microscopy. These findings were consistent with a diagnosis of Berger's disease. The occurrence of Henoch-Schönlein purpura at 4 years and Berger's disease at 15 years in the same patient suggests that these two conditions are related.