We are reporting four cases of steroid responsive nephrotic synbdrome which showed mesangial IgA deposition at immunofluoresence. In IgA nephropathy severe proteinuria is rare and more often associated with hypertension, steroid resistance, and a
tendency to renal insufficiency with severe renal histopathologic changes such as advanced glomerular sclerosis and crescent formation. But these cases exhibited minor glomerular alterations at light micrescopy despite of massive proteinuria.
Furthermire, these cases took a clinical course mimicking that of minimal change nephrotic syndrome, characterized by steroid responsive proteinuria, infrequent relapses (in case 2) absence of hematuria, and absence of renal insufficitency during
the
follow-up period.
However, we could diagnoses these cases by presence of mesangial IgA deposits at immunofluorescence. In conclusion, we could recommend use of corticosteroid particularly in case of the nephrotic syndrome associated with IgA nephropathy with minor
histopathologic change.
|