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Grosser DS, Persad P, Talento RV, et al. IgA-dominant infection-associated glomerulonephritis in the pediatric population. Pediatr Nephrol. 2021;doi: 10.1007/s00467-021-05245-y.
Grosser, D. S., Persad, P., Talento, R. V., Shoemaker, L. R., Hunley, T. E., Hidalgo, G., Subtirelu, M. M., Coventry, S., Baliga, R., & Fogo, A. B. (2021). IgA-dominant infection-associated glomerulonephritis in the pediatric population. Pediatric nephrology (Berlin, Germany), . https://doi.org/10.1007/s00467-021-05245-y
Grosser, Daniel S, et al. "IgA-dominant infection-associated glomerulonephritis in the pediatric population." Pediatric nephrology (Berlin, Germany) vol. (2021). doi: https://doi.org/10.1007/s00467-021-05245-y
Grosser DS, Persad P, Talento RV, Shoemaker LR, Hunley TE, Hidalgo G, Subtirelu MM, Coventry S, Baliga R, Fogo AB. IgA-dominant infection-associated glomerulonephritis in the pediatric population. Pediatr Nephrol. 2021 Aug 28; doi: 10.1007/s00467-021-05245-y. Epub 2021 Aug 28. PMID: 34453602.
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Pediatr Nephrol. 2021 Aug 28; doi: 10.1007/s00467-021-05245-y. Epub 2021 Aug 28.

IgA-dominant infection-associated glomerulonephritis in the pediatric population.

Pediatric nephrology (Berlin, Germany)

Daniel S Grosser, Paul Persad, Romualdo V Talento, Lawrence R Shoemaker, Tracy E Hunley, Guillermo Hidalgo, Mihail M Subtirelu, Susan Coventry, Radhakrishna Baliga, Agnes B Fogo

Affiliations

  1. Department of Pathology and Laboratory Medicine, University of Texas Health Science Center At San Antonio, San Antonio, TX, USA. [email protected].
  2. Laboratory for Kidney Pathology, Nashville, TN, USA.
  3. Eastern Carolina Pathology, Wilson, NC, USA.
  4. Department of Pediatrics, Division of Pediatric Nephrology, University of Florida College of Medicine, Gainesville, FL, USA.
  5. Division of Pediatric Nephrology, Monroe Carell Jr Children's Hospital At Vanderbilt, Nashville, TN, USA.
  6. Pediatric Nephrology, East Carolina University, Greenville, NC, USA.
  7. Pediatric Nephrology, Hackensack Meridian Health, Neptune, NJ, USA.
  8. Pediatric Nephrology and Hypertension, East Tennessee Children's Hospital, Knoxville, TN, USA.
  9. Department of Pathology, Norton Children's Hospital, Louisville, KY, USA.
  10. Tulane University School of Medicine, New Orleans, LA, USA.
  11. Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.

PMID: 34453602 DOI: 10.1007/s00467-021-05245-y

Abstract

BACKGROUND: IgA-dominant infection-associated glomerulonephritis is well-documented in adults but has not been studied in depth in children. We assessed the incidence of pediatric IgA-dominant infection-associated glomerulonephritis and clinical and kidney biopsy findings.

METHODS: Pediatric native kidney biopsies over a 10-year period with IgA dominance, strong C3, and findings indicative of infection-associated etiology were identified.

RESULTS: We identified 9 cases of IgA-dominant infection-associated glomerulonephritis, 0.8% of pediatric native kidney biopsies. Seven patients presented with elevated creatinine. All had hematuria and proteinuria. Eight patients had clinical evidence of infection: one each with central port infection by methicillin-sensitive Staphylococcus aureus, recurrent streptococcal pharyngitis and recent otitis media, streptococcal pharyngitis demonstrated 8 months after biopsy, suspected streptococcal scalded skin syndrome, and viral gastroenteritis, and three with serologic evidence of Streptococcal infection but no identified site of infection. All but one patient experienced short-term normalization of creatinine and resolution of proteinuria, though two eventually progressed to kidney failure: one 3 years later due to progressive disease and one 11 years later due to focal segmental glomerulosclerosis without concurrent immune deposits.

CONCLUSIONS: Pediatric IgA-dominant infection-associated glomerulonephritis is rare, and generally has a favorable prognosis, contrasting that seen in adults with severe comorbidities. A higher resolution version of the Graphical abstract is available as Supplementary.

© 2021. IPNA.

Keywords: Glomerulonephritis; IgA-dominant; Infection-associated; Pediatric

References

  1. Rodriguez-Iturbe B, Batsford S (2007) Pathogenesis of poststreptococcal glomerulonephritis a century after Clemens von Pirquet. Kidney Int 71:1094–1104. https://doi.org/10.1038/sj.ki.5002169 - PubMed
  2. Kanjanabuch T, Kittikowit W, Eiam-Ong S (2009) An update on acute postinfectious glomerulonephritis worldwide. Nat Rev Nephrol 5:259–269. https://doi.org/10.1038/nrneph.2009.44 - PubMed
  3. Nasr SH, Markowitz GS, Stokes MB, Said SM, Valeri AM, D’Agati VD (2008) Acute postinfectious glomerulonephritis in the modern era: experience with 86 adults and review of the literature. Medicine (Baltimore) 87:21–32. https://doi.org/10.1097/md.0b013e318161b0fc - PubMed
  4. Nasr SH, Markowitz GS, Whelan JD, Albanese JJ, Rosen RM, Fein DA, Kim SS, D’Agati VD (2003) IgA-dominant acute poststaphylococcal glomerulonephritis complicating diabetic nephropathy. Hum Pathol 34:1235–1241. https://doi.org/10.1016/s0046-8177(03)00424-6 - PubMed
  5. Glassock RJ, Alvarado A, Prosek J, Hebert C, Parikh S, Satoskar A, Nadasdy T, Forman J, Rovin B, Hebert LA (2015) Staphylococcus-related glomerulonephritis and poststreptococcal glomerulonephrtitis: why defining “post” is important in understanding and treating infection-related glomerulonephritis. Am J Kidney Dis 65:826–832. https://doi.org/10.1053/j.ajkd.2015.01.023 - PubMed
  6. Worawichawong S, Girard L, Trpkov K, Gough JC, Gregson DB, Benediktsson H (2011) Immunoglobulin A-dominant postinfectious glomerulonephritis: frequent occurrence in nondiabetic patients with Staphylococcus aureus infection. Hum Pathol 42:279–284. https://doi.org/10.1016/j.humpath.2010.07.009 - PubMed
  7. Wallace E, Maillard N, Ueda H, Hall S, Fatima H, Novak J, Julian BA (2014) Immune profile of IgA-dominant diffuse proliferative glomerulonephritis. Clin Kidney J 7:479–483. https://doi.org/10.1093/ckj/sfu090 - PubMed
  8. Guillen AOO, Silva RIV, Gonzalez BM, Guell YA, Fossas PG, Gomez IGC, Araujo OM, Abraham VS, Piccoli GB, Madero M (2019) Acute IgA-dominant glomerulonephritis associated with syphilis infection in a pregnant teenager: a new disease association. J Clin Med 8:114. https://doi.org/10.3390/jcm8010114 - PubMed
  9. Pertschuk LP, Vuletin JC, Sutton AL, Velazquez LA (1976) Demonstration of antigen and immune complex in glomerulonephritis due to Staphylococcus aureus infection. Am J Clin Pathol 66:1027. https://doi.org/10.1093/ajcp/66.6.1027 - PubMed
  10. Nasr SH, D’Agati VD (2011) IgA-dominant postinfectious glomerulonephritis: a new twist on an old disease. Nephron Clin Pract 119:c18–c26. https://doi.org/10.1159/000324180 - PubMed
  11. Bu R, Li Q, Duan ZY, Wu J, Chen P, Chen XM, Cai GY (2015) Clinicopathologic features of IgA-dominant infection-associated glomerulonephritis: a pooled analysis of 78 cases. Am J Nephrol 41:98–106. https://doi.org/10.1159/000377684 - PubMed
  12. Haas M, Racusen LC, Bagnasco SM (2008) IgA-dominant postinfectious glomerulonephritis: a report of 13 cases with common ultrastructural features. Hum Pathol 39:1309–1316. https://doi.org/10.1016/j.humpath.2008.02.015 - PubMed
  13. Satoskar AA, Nadasdy G, Plaza JA, Sedmak D, Shidham G, Hebert L, Nadasdy T (2006) Staphylococcus infection-associated glomerulonephritis mimicking IgA nephropathy. Clin J Am Soc Nephrol 1:1179–1186. https://doi.org/10.2215/CJN.01030306 - PubMed
  14. Jennette JC (1988) The immunohistology of IgA nephropathy. Am J Kidney Dis 12:348–352. https://doi.org/10.1016/s0272-6386(88)80022-2 - PubMed
  15. Orfila C, Rakotoarivony J, Yves M, Suc JM (1988) Immunofluorescence characterization of light chains in human nephropathies. Virchows Archiv A Pathol Anat Histopathol 412:591–594. https://doi.org/10.1007/BF00844295 - PubMed
  16. Kitamura M, Obata Y, Ota Y, Muta K, Yamashita H, Harada T, Mukae H, Nishino T (2019) Significance of subepithelial deposits in patients diagnosed with IgA nephropathy. PLoS ONE 14:e0211812. https://doi.org/10.1371/journal.pone.0211812 - PubMed
  17. Uppin MS, Prayaga AK, Srinivas BH, Rapur R, Desai M, Dakshina Murthy KV (2011) Light chain immunofluorescence in various nephropathies. Indian J Pathol Microbiol 54:55–58. https://doi.org/10.4103/0377-4929.77325 - PubMed
  18. Rodriguez-Iturbe B, Musser JM (2008) The current state of poststreptococcal glomerulonephritis. J Am Soc Nephrol 19:1855–1864. https://doi.org/10.1681/ASN.2008010092 - PubMed
  19. White AV, Hoy WE, McCredie DA (2001) Childhood post-streptococcal glomerulonephritis as a risk factor for chronic renal disease in later life. Med J Aust 174:492–496. https://doi.org/10.5694/j.1326-5377.2001.tb143394.x - PubMed
  20. Satoskar AA, Molenda M, Scipio P, Shim R, Zirwas M, Variath RS, Brodsky SV, Nadasdy GM, Hebert L, Rovin B, Nadasdy T (2013) Henoch-Schönlein purpura-like presentation in IgA-dominant Staphylococcus infection-associated glomerulonephritis–a diagnostic pitfall. Clin Nephrol 79:302–312. https://doi.org/10.5414/CN107756 - PubMed
  21. Mahmood T, Puckrin R, Sugar L, Naimark D (2018) Staphylococcus-associated glomerulonephritis mimicking Henoch-Schönlein purpura and cryoglobulinemic vasculitis in a patient with an epidural abscess: a case report and brief review of the literature. Can J Kidney Health Dis 5:2054358118776325. https://doi.org/10.1177/2054358118776325 - PubMed
  22. Mandai S, Aoyagi M, Nagahama K, Arai Y, Hirasawa S, Aki S, Inaba N, Tanaka H, Tsuura Y, Tamura T, Sasaki S (2013) Post-staphylococcal infection Henoch-Schönlein purpura nephritis: a case report and review of the literature. Ren Fail 35:869–874. https://doi.org/10.3109/0886022X.2013.794703 - PubMed
  23. Satoh M, Okabe H, Orikasa R, Yamamoto T (2016) Henoch-Schönlein purpura (IgA vasculitis) developing after postoperative wound infection by methicillin-resistant Staphylococcus aureus. Our Dermatol Online 7:207–209 - PubMed
  24. Pouria S, Feehally J (1999) Glomerular IgA deposition in liver disease. Nephrol Dial Transplant 14:2279–2282. https://doi.org/10.1093/ndt/14.10.2279 - PubMed

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