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• W1992352069 abstract "A 54-year-old white man was admitted to the New England Medical Center (NEMC) for a percutaneous renal biopsy. Four years earlier mild hypertension and 3+ proteinuria had been discovered during a routine physical examination. At that time the serum creatinine was 1.2 mg/dI and the BUN was 15 mg/dl. Intravenous pyelography revealed normally functioning kidneys; the right measured 12.5 cm and the left 13.5 cm. Treatment with hydrochlorothiazide and reserpine was begun. Two and one-half years before admission, the serum creatinine was 1.8 mg/dl and the BUN was 24 mg/dl. One and one-half years before admission, urinalysis revealed 4+ protein and 15 to 25 red blood cells per high-power field; the serum creatinine was 2.1 mg/dl and the BUN 29 mg/dl. Three months prior to admission the serum creatinine was 2.6 mg/dl and the BUN 28 mg/dl; 24-hour urine protein excretion was 12 g. Physical examination revealed a blood pressure of 200/100 mm Hg. Funduscopic examination showed only arteriovenous nicking. The lungs were clear to percussion and auscultation. Cardiac examination revealed normal SI and S2 sounds without rubs, murmurs, or gallops. There was 1 + pretibial edema. The remainder of the examination was unrevealing. Laboratory studies revealed the following pertinent data. Urinalysis disclosed a specific gravity of 1.017, a pH of 6, 2+ protein, and 2+ blood. Microscopic examination of the sediment revealed 50 to 80 red blood cells and I to 3 white blood cells per high-power field, hyaline casts, and one pigmented cast. A urine culture was sterile. The serum creatinine was 3.8 mg/dl and the BUN was 38 mg/dl. The 24-hour urine protein excretion was 5.7g. Light microscopic study of the renal biopsy material revealed benign nephrosclerosis and acute interstitial nephritis with eosinophils predominating in the cell infiltrate. Immunofluorescence microscopy revealed 4+ mesangial deposits of IgA, trace to 2+ mesangial deposits of IgG, trace to 3+ mesangial deposits of C3, trace to 1+ mesangial deposits of C4, and no 1gM; these findings were thought to be diagnostic of IgA nephropathy. A short course of prednisone, given to treat possible diuretic-induced allergic interstitial nephritis, had no demonstrable effect, and the patient's renal function continued to deteriorate. Sixteen months after the renal biopsy was performed, the serum creatinine was 10.2 mg/dl and the BUN was ill mg/dl. Hemodialysis was instituted and plans were made for renal transplantation." @default.
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• W1992352069 date "1984-04-01" @default.
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• W1992352069 title "Idiopathic IgA nephropathy" @default.
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• W1992352069 doi "https://doi.org/10.1038/ki.1984.79" @default.
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