Mesangial IgA Immunofluorescence in Idiopathic Renal Hematuria

Melinda McVicar, MD; Anthony D. Nicastri, MD; Eli A. Friedman, MD
Arch Intern Med. 1976;136(9):1067. doi:10.1001/archinte.1976.03630090089022.
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To the Editor.—  In the September 1975 issue of the Archives (135:1204-1211), Drs Kupor, Mullins, and McPhaul, address themselves to the topic of immunopathologic findings in idiopathic renal hematuria.We have been interested in the association of idiopathic renal hematuria and the immunopathologic finding of predominantly mesangial IgA immunofluorescence in biopsy specimens from individuals with this clinical syndrome. We have to date analyzed 13 patients whose renal biopsy specimens had predominantly mesangial deposition of IgA. Three of these had severe impairment of renal function. In contrast to the experience of Kupor and associates, one of these patients initially had a creatinine clearance of 97 ml/min/1.73 sq m at age 20, after four years of recurrent bouts of gross hematuria. Four years later, he required chronic hemodialysis for renal insufficiency. The other two patients with severe impairment of renal function had onset of idiopathic hematuria at age 16 years and 32


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