Tota Maciej, Baron Vanessa, Musial Katie, Derrough Bouchra, Konieczny Andrzej, Krajewska Magdalena, Turkmen Kultigin, Kusztal Mariusz
Faculty of Medicine, Wroclaw Medical University, 50-367 Wrocław, Poland.
Faculty of Dentistry, Wroclaw Medical University, 50-435 Wrocław, Poland.
J Clin Med. 2023 Apr 6;12(7):2726. doi: 10.3390/jcm12072726.
Primary (pIgAN), secondary IgA nephropathy (sIgAN), and IgA-associated nephropathy can be distinguished. While pIgAN has been thoroughly studied, information about the etiology of sIgAN remains scarce. As concerns sIgAN, several studies suggest that different etiologic factors play a role and ultimately lead to a pathophysiologic process similar to that of pIgAN. In this article, we review a vast number of cases in order to determine the novel putative underlying diseases of sIgAN. Moreover, updates on the common pathophysiology of primary disorders and sIgAN are presented. We identified liver, gastrointestinal, oncological, dermatological, autoimmune, and respiratory diseases, as well as infectious, iatrogenic, and environmental factors, as triggers of sIgAN. As novel biological therapies for listed underlying diseases emerge, we suggest implementing drug-induced sIgAN as a new significant category. Clinicians should acknowledge the possibility of sIgAN progression in patients treated with TNF-α inhibitors, IL-12/IL-23-inhibitors, immune checkpoint inhibitors, CTLA-4, oral anticoagulants, thioureylene derivatives, and anti-vascular endothelial growth factor drugs.
原发性IgA肾病（pIgAN）、继发性IgA肾病（sIgAN）和IgA相关性肾病可以相互区分。虽然pIgAN已得到充分研究，但关于sIgAN病因的信息仍然匮乏。关于sIgAN，多项研究表明不同的病因因素起作用，并最终导致与pIgAN相似的病理生理过程。在本文中，我们回顾了大量病例，以确定sIgAN潜在的新的相关疾病。此外，还介绍了原发性疾病和sIgAN常见病理生理学的最新进展。我们确定肝脏、胃肠道、肿瘤、皮肤、自身免疫和呼吸系统疾病，以及感染、医源性和环境因素是sIgAN的触发因素。随着针对所列相关疾病的新型生物疗法的出现，我们建议将药物性sIgAN作为一个新的重要类别纳入其中。临床医生应认识到接受肿瘤坏死因子-α抑制剂、白细胞介素-12/白细胞介素-23抑制剂、免疫检查点抑制剂、细胞毒性T淋巴细胞相关蛋白4、口服抗凝剂、硫脲类衍生物和抗血管内皮生长因子药物治疗的患者发生sIgAN进展的可能性。
