IgA nephropathy can take many variants. Classically, it can
present as the nephritic syndrome but can be just benign hematuria with no
other complaints. Sometimes it can be aggressive with crescents and or
TMA. Proteinuria usually suggest a bad
prognostic marker in IgA nephropathy.
Sudden onset proteinuria might suggest a dual glomerular process or IgA
nephropathy with a minimal change disease variant. A recent series of cases have been described
in CJASN. A retrospective review of pathology cases in
the Columbia Univ path database revealed 17 such cases. Most had normal creatinine, proteinuria was
over 8g for average and biopsy showed co dominant IgA with mesangial deposits
and MCD. 14/17 patients got complete
remission with steroids and additional agents.
Another case presented in this case report.
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