Abstract

Jawad Fadhil Al-Tu’ma* and Riyadh Muhi Al-Saegh

ABSTRACT

Background: Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis that occurs globally and is documented as a major cause of end-stage renal disease worldwide. IgAN is more common in males than in females. The prevalence of IgAN in Iraq is 3.5% from single center study in 2013. Patients with IgAN may be asymptomatic, with persistent microscopic hematuria and proteinuria and often hypertension. IgAN appears to be a systemic disease in which the kidneys are damaged as innocent by standers, because IgAN frequently recurs after transplantation. Aim of the study: To study the cases of IgAN with regard to their clinical, light microscopic, immunofluorescence presentation and compared our findings with the other published researches inside and outside Iraq. Patients and Methods: This is a retrospective study in lasted two years from January 2017 to December 2018. Patient’s data were collected from 64 patients who suspected to have primary glomerulonephritis including IgAN. The patients were presented in the last two years in Alkafeel Hospital / Kerbala - Iraq and Al-Hussein Teaching Hospital, Al-Hussain Medical City, Kerbala Health Directorate / Kerbala - Iraq, referred to nephrology center at different duration times. All patients underwent routine physical and various investigations in the form of complete blood count, erythrocyte sedimentation rate, renal function test, electrolytes, liver function test, bleeding profile (PT, PTT, INR), bleeding time, virology screen, urinalysis, 24 hours urine protein and/or spot urine protein to creatinine ratio, and glomerular filtration rate. In addition to the above mentioned workup, specific investigations were done including: (ANA, Anti-ds DNA) by ELISA technique, (C3, C4) by nephelometry technique, and serum IgA level in some patients. All patients underwent kidney biopsy according to standard procedure by Kerstin Amann, and their tissue specimens were studied in the laboratory with LM by using the following stains: Hematoxylin and eosin, Periodic acid–Schiff (PAS), Trichrome, Methenamine silver. In addition, with IF microscope reagents, the relationship between the clinical presentations and IF deposits in kidney biopsy of all patients were studied using the statistical analysis of Pearson correlation and single table student's T test. A P value