Clinicopathological Studies of Immunoglobulin A Associated Idiopathic Glomerulonephritis in Childhood

The consecutive renal biopsy specimens of 151 children cases were immunofluorescentically, mor-phologically and clinically examined. Especially attention was paid to the cases having glomerular IgA deposition, and the cli.nicopa thological outcomes among the cases showing different patterns of the IgA depositions were studied. Morphologically, the examined cases included 6 membranous nephropathy, 13 membranoproli ferative glomerulonephritis, 7 incomplete membranoproliferative glomerulonephritis, 1 diffuse ores centic glomerulonephritis, 29 proli.ferative glomerulonephritis, 94 minor glomerular abnormalities and. 1 End Stage Kidney cases. By immunofluorescence, the cases with positive glomerular deposition of IgA, IgG and IgM were found in 28, 24 and 26% of total examined cases respectively. These im munoglobulins were mainly found granularly either along the glomerular capillary, mesangially or mesangiocapillary. In another respect, IgA positive cases were found in 55% of morphological proli-ferative glomerulonephritis cases and also noted in relatively high percentages in other types of glomerulonephritis. Comparing the cases with mesangial pattern of IgA deposition in the glomeruli to those with mesangiocapillary pattern, the formers were classified to the clinicopathologically rather milder group than the latters. Furthermore, within IgA mesangial pattern group of 14 cases showing segmentall mesangial deposition of IgA were found in 43%, and all of them revealed morphologically only slightt alterations. However, the cases with global mesangial deposition of IgA represented morphologically rather progressive proliferative glomerulonephritis. On the other hand, IgA mesangiocapillary pat-tern group consisted of morphologically rather advanced change cases and they all showing globall intraglomeralar deposition of IgA. As a resul, it was noted that IgA deposition in the glomeruli were seemed to be very common among the glomerulonephritis of childhood. Within the cases having the different patterns of in traglomerular IgA deposition, although the most cases of IgA mesangial pattern group may be in-cluded simplified disease entity of IgA nephropathy.