In order to find out differences in clinical an pathologic features according to mode of onset, 101 children with IgA nephropathy were classified into three groups; 1) NRP group(nephrotic range proteinuria, n=21), 2) NS group(nephrotic syndrome,
n=17),
3) RGH group (recurrent gross hematuria, n=63). The clinical and pathological findings of the three groups were analyzed. Males predominate over females in RGH group, while female predilection is obsereved in NRP and NS group(p<0.01). The
proportion of
glomeruli showing segmental sclerosis was Higher in NRP group than in RGH group (p<0.03). The proportion of glomeruli showing cresents and diffuse, moderate mesangial proliferation was higher in NRP group than in NS and/or RGH group (p<0.01). The
incidence of the tubulointerstitial changes was higher in NRP group than in RGH group(p<0.01). IgA deposits on the glomerular capillary walls were found more frequently in NS group than in RGH group(p<0.01). The frequency of abnormalities of
glomerular
basement membrane and subepithelial/subendothelial immune deposition was higher in NS group than in RGH group(p<0.01).
In conclusion IgA nephropathy is a heterogeneous syndrome and it can be classified into at least three groups with different clinical and pathologic features according to its presentation at onset. Long-term follow-up beyond pediatric age is
required
for determination of prognosis of those three groups.
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