Baraldi Olga, Comai Giorgia, Cuna Vania, Cappuccilli Maria, Serra Carla, Ronco Claudio, La Manna Gaetano
Contrib Nephrol. 2017;190:108-116. doi: 10.1159/000468955. Epub 2017 May 23.
IgA nephropathy (IgAN) is the most common primary glomerulonephritis in developed countries and a leading cause of chronic kidney disease. IgAN is a mesangial proliferative glomerulonephritis characterized by diffuse mesangial deposition of IgA, often accompanied by the deposition of IgG and the C3 component of complement in a similar distribution. This condition is in most cases oligosymptomatic, often discovered coincidentally. Currently, there is no specific treatment available for IgAN and the use of immunosuppression therapy is debated. Due to immune-mediated pathogenic nature of IgAN, therapy with mycophenolate mofetil (MMF), a potent immunosuppressive agent, could be effective in patients at risk for progressive disease. In this paper, we discuss the case of an IgAN patient treated with MMF at our center, followed by a review of the literature and our previous experience on the potential renoprotective effects of MMF in IgAN patients with different clinical presentation, despite adequate angiotensin blockade and steroid therapy.
IgA肾病（IgAN）是发达国家最常见的原发性肾小球肾炎，也是慢性肾脏病的主要病因。IgA肾病是一种系膜增生性肾小球肾炎，其特征是IgA在系膜弥漫性沉积，常伴有IgG和补体C3成分在相似分布区域沉积。这种疾病在大多数情况下症状较少，常被偶然发现。目前，尚无针对IgA肾病的特异性治疗方法，免疫抑制疗法的使用存在争议。由于IgA肾病具有免疫介导的致病特性，霉酚酸酯（MMF）作为一种强效免疫抑制剂，对有疾病进展风险的患者可能有效。在本文中，我们讨论了在我们中心接受MMF治疗的一名IgA肾病患者的病例，随后回顾了文献以及我们之前关于MMF对不同临床表现的IgA肾病患者潜在肾脏保护作用的经验，尽管已进行了充分的血管紧张素阻断和类固醇治疗。
