A Clinicohistopathological Study of IgA Nephropathy Associated with Nephrotic Syndrome

Among the 201 cases of IgA nephropathy, a study was made of the clinical characteristics, laboratory findings, and histopathological findings of 11 cases (5.5%) presenting nephrotic syndrome in comparison with those of a non-nephrotic group. The results of this study showed that in comparison with the non-nephrotic group the frequency of hypertension, anemia, and depressed renal function was higher in the nephrotic group and that the histological damage was severer. As can be expected, the frequency of severe proteinuria, hypoproteinemia, and depressed serum IgG value was higher in the nephrotic group, but no significant difference could be demonstrated in degree of hematuria, serum IgA value, and immunofluorescence findings. Furthermore, the response to various treatments was unfavorable and in 3 cases chronic renal failure developed. In general, in many of the cases the prognosis is poor.
On the other hand, the authors experienced one case with minimal change in the histological picture which responded favorably to steroid administration. The significance of such a case is yet unknown.