Results of a survey of the relationship between palatine tonsil and IgA nephropathy

To investigate the relationship between palatine tonsil and IgA nephropathy, a survey was performed by questionnaire to 154 non-ENT medical doctors who had reported case of IgA nephropathy. The questionnaire was sent in February 1997, and answers were obtained within one month from 93 doctors (79 internal physicians, 12 pediatricians and 2 pathologists); a 60.4% response rate. A total of 72.0% of doctors answered that renal pathology was the most important prognostic factor for IgA nephropathy. A total of 73.1% of doctors thought that the administration of corticosteroid was the most effective therapy for IgA nephropathy, whereas only one doctor answered that tonsillectomy was most effective. Urine protein was the most useful factor for the estimation of the treatment, according to 37.6% of doctors. The majority of doctors who replied to the questionnaire thought that palatine tonsil seemed to be involved in the pathophysiology of IgA nephropathy in less than half of patients with IgA nephropathy. In addition, they answered that the rate of patients with IgA nephropathy to whom tonsillectomy was effective was also less than 50%. The tonsillar provocation test was rarely performed for the diagnosis of tonsillar focal infection in IgA nephropathy. Furthermore, 51.6% doctors answered that urine protein was the most important factor in any estimation of the provocation test.