IgA nephropathy (also known as Berger's disease) is the most common form of glomerulonephritis. It affects patients of all ages. The clinical picture consists mainly of haematuria or recurrent haematuria. The course of the disease is an individual feature. Up to 20% of patients may develop end-stage renal disease, which requires dialysis.
IgA Nephropathy , also known asBerger's diseasenamed after the author who first described the pathophysiology of the disease, consists of an overproduction of immunoglobulin And in the mucous membranes. In response to pathogens - e.g. bacterial antigens in the digestive or respiratory system, IgA complexes are formed. In the digestive system, the dominant causative factor is the popularEscherichia coli , while the respiratory system is mainly colonized with β-hemolytic streptococci and influenza viruses. IgA nephropathy may also appear in the course of autoimmune diseases, including rheumatoid disorders, such as:
- hepatitis B
- celiakia
- sarcoidosis
- psoriasis
- ankylosing spondylitis (zzsk)
- rheumatoid arthritis
- reactive arthritis
- inflammatory bowel disease
- AIDS
Excess nephrotoxic complexes build up in the glomeruli, leading to their damage.
IgA nephropathy: symptoms and course
The most pathognomonic symptom of the disease is recurrent hematuria or hematuria. In the first phase, symptoms of a developing viral or bacterial infection are observed. The spectrum of symptoms varies depending on the occupied system. After about 48 hours, changes in urine appear.
Berger Disease can occur at any age, but it is by far the most common in children and young adults.
The natural course of Berger's disease is hematuria, which lasts up to several days, followed by hematuria with accompanying proteinuria. Symptoms tend to recur and subsequent episodes look similar. Periods of remission can last up to several years.
It is worth mentioning that the period of hematuriais associated with mild renal failure and transient arterial hypertension. Typically, Berger's disease is chronic and can last up to 20 years.
In most cases, episodes of relapse are mild. Factors that worsen the prognosis include: concomitant arterial hypertension, proteinuria, diagnosed glomerular sclerosis or frequent episodes of hematuria.
How to recognize Berger disease?
The standard urine general examination may not be sufficient for a definitive diagnosis. Usually, more extensive diagnosis is indicated. A biopsy is required to determine the cause of impaired kidney function. A small fragment of the kidney is collected and sent for histopathological examination.
Treating Berger's disease
So far, no targeted treatment has been established. Usually, the therapeutic procedure is modified depending on the presented symptoms. If we are dealing with deteriorating kidney function and accompanying proteinuria, immunosuppression is necessary.
The course of Igra nephropathy is difficult to predict. Up to 20% of patients may develop end-stage renal disease requiring dialysis. Factors that worsen the prognosis include arterial hypertension, proteinuria and elevated serum creatinine levels.