IgA nephropathy laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
==Laboratory Findings== | ==Laboratory Findings== | ||
In children and younger adults, the history and association with respiratory infection can raise the suspicion of IgA nephropathy directly. A [[urinalysis]] will show [[red blood cells]], usually as red cell [[ urinary casts]]. [[Proteinuria]], usually less than 2 grams per day, also may be present. Other [[renal]] causes of isolated hematuria include [[thin basement membrane disease]] and [[Alport syndrome]], the latter being a [[hereditary disease]] associated with [[hearing impairment]]. A kidney [[needle aspiration biopsy|biopsy]] is necessary to confirm the diagnosis. The biopsy specimen shows proliferation of the [[mesangium]], with IgA deposits on [[immunofluorescence]] and [[electron microscopy]]. However, all patients with isolated [[microscopic hematuria]] (i.e. without associated proteinuria and with normal [[kidney function]]) are not usually biopsied since this is associated with an excellent [[prognosis]]. | In children and younger adults, the history and association with respiratory infection can raise the suspicion of IgA nephropathy directly. A [[urinalysis]] will show [[red blood cells]], usually as red cell [[ urinary casts]]. [[Proteinuria]], usually less than 2 grams per day, also may be present.<ref name="pmid11576875">{{cite journal| author=Bartosik LP, Lajoie G, Sugar L, Cattran DC| title=Predicting progression in IgA nephropathy. | journal=Am J Kidney Dis | year= 2001 | volume= 38 | issue= 4 | pages= 728-35 | pmid=11576875 | doi=10.1053/ajkd.2001.27689 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11576875 }} </ref> Other [[renal]] causes of isolated hematuria include [[thin basement membrane disease]] and [[Alport syndrome]], the latter being a [[hereditary disease]] associated with [[hearing impairment]]. A kidney [[needle aspiration biopsy|biopsy]] is necessary to confirm the diagnosis. The biopsy specimen shows proliferation of the [[mesangium]], with IgA deposits on [[immunofluorescence]] and [[electron microscopy]]. However, all patients with isolated [[microscopic hematuria]] (i.e. without associated proteinuria and with normal [[kidney function]]) are not usually biopsied since this is associated with an excellent [[prognosis]]. | ||
Other [[blood test]]s done to aid in the diagnosis include [[C-reactive protein|CRP]] or [[erythrocyte sedimentation rate|ESR]], [[Complement system|complement]] levels, [[Anti-nuclear antibody|ANA]], ANCA and [[lactate dehydrogenase|LDH]]. [[Protein electrophoresis]] and [[antibody|immunoglobulin]] levels can show increased IgA1 in 30% to 50% of all patients. may be normal or reduced. Tests such as [[electrolyte]]s, [[renal function]] ([[creatinine]], [[urea]]), total protein, [[serum albumin]] help in establishing the [[prognosis]]. Other tests such as [[bleeding time]], [[full blood count]], [[Prothrombin time|PT]] and [[Partial thromboplastin time|PTT]] are done before performing a biopsy. | Other [[blood test]]s done to aid in the diagnosis include [[C-reactive protein|CRP]] or [[erythrocyte sedimentation rate|ESR]], [[Complement system|complement]] levels, [[Anti-nuclear antibody|ANA]], ANCA and [[lactate dehydrogenase|LDH]]. [[Protein electrophoresis]] and [[antibody|immunoglobulin]] levels can show increased IgA1 in 30% to 50% of all patients. may be normal or reduced. Tests such as [[electrolyte]]s, [[renal function]] ([[creatinine]], [[urea]]), total protein, [[serum albumin]] help in establishing the [[prognosis]]. Other tests such as [[bleeding time]], [[full blood count]], [[Prothrombin time|PT]] and [[Partial thromboplastin time|PTT]] are done before performing a biopsy. | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 22:29, 27 September 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Laboratory Findings
In children and younger adults, the history and association with respiratory infection can raise the suspicion of IgA nephropathy directly. A urinalysis will show red blood cells, usually as red cell urinary casts. Proteinuria, usually less than 2 grams per day, also may be present.[1] Other renal causes of isolated hematuria include thin basement membrane disease and Alport syndrome, the latter being a hereditary disease associated with hearing impairment. A kidney biopsy is necessary to confirm the diagnosis. The biopsy specimen shows proliferation of the mesangium, with IgA deposits on immunofluorescence and electron microscopy. However, all patients with isolated microscopic hematuria (i.e. without associated proteinuria and with normal kidney function) are not usually biopsied since this is associated with an excellent prognosis.
Other blood tests done to aid in the diagnosis include CRP or ESR, complement levels, ANA, ANCA and LDH. Protein electrophoresis and immunoglobulin levels can show increased IgA1 in 30% to 50% of all patients. may be normal or reduced. Tests such as electrolytes, renal function (creatinine, urea), total protein, serum albumin help in establishing the prognosis. Other tests such as bleeding time, full blood count, PT and PTT are done before performing a biopsy.
References
- ↑ Bartosik LP, Lajoie G, Sugar L, Cattran DC (2001). "Predicting progression in IgA nephropathy". Am J Kidney Dis. 38 (4): 728–35. doi:10.1053/ajkd.2001.27689. PMID 11576875.