Mota F, Lunar O R, Gordillo G
Bol Med Hosp Infant Mex. 1980 Nov-Dec;37(6):1123-34.
Clinical correlations and evolution were studied in 34 biopsies from patients with the following diagnosis: Henoch-Schönlein purpura in 17, monosymptomatic hematuria in 11, idiopathic nephrotic syndrome in 3, and Fanconi Syndrome, Systemic lupus erythematosus and tubulointerstitial nephritis, one for each diagnosis respectively. All these biopsies showed anti-IgA mesangial deposits, by immunofluorescence techniques with variable morphology by light microscopy. Endo and extracapillary proliferation was the most frequent lesions. Twenty cases had follow-up observation for over 2 years: 7 cases were in remission, hematuria and/or proteinuria persisted in 10 and 3 cases progressed to chronic renal failure. In conclusion, mesangial IgA deposits are not an infrequent finding in renal biopsies performed in the Hospital Infantil de México. Although the predominant clinical diagnosis was either Henoch-Schönlein purpura or monosymptomatic hematuria, other diagnosis were also found. Some cases with this mesangiopathy presented as idiopathic nephrotic syndrome or post-streptococcal glomerulonephritis, but with serum complement within normal levels. Long-term prognosis was related to glomerular morphology as in other glomerulopathies.
对34例患者的活检样本进行了临床相关性及病情演变研究，这些患者的诊断如下：17例为过敏性紫癜，11例为单纯性血尿，3例为特发性肾病综合征，以及分别各1例的范科尼综合征、系统性红斑狼疮和肾小管间质性肾炎。通过免疫荧光技术，所有这些活检样本均显示系膜区有IgA沉积，光学显微镜下形态各异。内皮细胞和毛细血管外增生是最常见的病变。20例患者进行了超过2年的随访观察：7例缓解，10例血尿和/或蛋白尿持续存在，3例进展为慢性肾衰竭。总之，在墨西哥儿童医院进行的肾活检中，系膜区IgA沉积并非罕见发现。尽管主要临床诊断为过敏性紫癜或单纯性血尿，但也发现了其他诊断。一些患有这种系膜病的病例表现为特发性肾病综合征或链球菌感染后肾小球肾炎，但血清补体水平正常。与其他肾小球疾病一样，长期预后与肾小球形态有关。
