Sicca syndrome in mesangial IgA glomerulonephritis

Area of Science:

• Nephrology
• Ophthalmology
• Immunology

Background:

• Mesangial Immunoglobulin A (IgA) glomerulonephritis (GN) is a primary glomerular disease.
• Oropharyngeal and ocular manifestations are increasingly recognized in systemic autoimmune conditions.
• The extrarenal features of IgA-GN require further elucidation.

Purpose of the Study:

• To investigate the prevalence of sicca syndrome in patients with IgA-GN compared to non-IgA-GN and healthy controls.
• To explore potential ocular surface abnormalities in IgA-GN patients.

Main Methods:

• Evaluated Schirmer-test, conjunctivitis history, salivary gland scintigraphy, and SSA/SSB (Ro/La) antibodies.
• Included 24 patients with IgA-GN, 58 with non-IgA-GN, and 100 healthy controls.

Main Results:

• Sicca syndrome (positive Schirmer-test) was significantly more prevalent in IgA-GN patients (46%) compared to non-IgA-GN (17%) and controls (8%) (p < 0.001).
• 17% of IgA-GN patients reported a history of recurrent conjunctivitis requiring ophthalmological treatment.
• Only one patient self-reported conjunctival xerosis, indicating potential underreporting of symptoms.

Conclusions:

• Diminished tear production is a frequent extrarenal manifestation in mesangial IgA-GN.
• Ocular surface abnormalities, such as sicca syndrome, should be considered in the comprehensive evaluation of IgA-GN.
• Further research into immune-mediated mechanisms of ocular involvement in IgA-GN is warranted.