Fast Five Quiz: IgA Nephropathy Presentation and Diagnosis

A. Brent Alper, Jr, MD, MPH


September 18, 2023

Renal biopsy is performed to confirm diagnosis. Biopsy specimens are studied in three different ways to identify histologic findings consistent with IgA nephropathy, light microscopy, electron microscopy, and immunofluorescence. It is important to note that immunofluorescence findings provide the pathologic features of this disease.

The most common light microscopy findings are diffuse mesangial proliferation and extracellular matrix expansion of the glomerulus. Sometimes, patients have focal glomerular sclerosis that cannot be distinguished from focal segmental glomerulosclerosis on light microscopy.

Findings that are observed in advanced disease include interstitial fibrosis, tubular atrophy, and vascular sclerosis. A small minority of patients have segmental necrotizing lesions with crescent formation owing to extensive disruption of the capillaries.

Learn more about histologic findings in the workup of IgA nephropathy.

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