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Submitted: 20 Feb 2024
Accepted: 25 Jun 2024
ePublished: 29 Jun 2024
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J Nephropharmacol. 2024;13(2): e12705.
doi: 10.34172/npj.2024.12705
  Abstract View: 130
  PDF Download: 48

Review

Comparative histological and clinical differences between children and adults in IgA nephropathy

Samaneh Zandifar 1 ORCID logo, Azadeh Khayyat 2 ORCID logo, Arefeh Zahmatkesh 1* ORCID logo, Mohammad Ali Esmaeil pour 3 ORCID logo

1 Nickan Research Institute, Isfahan, Iran
2 Medical College of Wisconsin, Pathology Department, Milwaukee, WI, USA
3 Medical College of Georgia, Augusta University, Rheumatology Department, Augusta, GA, USA
*Corresponding Author: Arefeh Zahmatkesh, Email: arefeh.zhmtksh@gmail.com

Abstract

IgA nephropathy (IgAN), as an autoimmune-mediated kidney disease worldwide, is considered an important cause of end-stage renal disease in adults. The most important diagnostic method in the patients is the evaluation of the biopsy findings. To date, several studies have examined different histopathological findings in patients with IgAN with an attempt to find out the relationship between morphologic findings with outcome and disease progression. Although there have been limited reports of IgAN in children, the Oxford scoring system is currently the most widely used IgAN classification and is validated for use in children and adults. In this review, we examined the most frequently published pathological findings on IgAN with a focus on Oxford classification between adults and children and attempted to highlight the key differences. The main purpose of this study was to assess the prognosis of patients with IgAN in childhood and adulthood, with emphasis on pathological risk factors for disease progression. Our results indicated that acute glomerulonephritis in children was predominantly reported more than chronic lesions. In addition, mesangial and endocapillary lesions were more common in children than in adults. In contrast, glomerular sclerosis, tubular atrophy/interstitial fibrosis, and atherosclerotic lesions were more common in older individuals.

Implication for health policy/practice/research/medical education:

In children, IgAN often presents as an acute form of glomerulonephritis, typically lacking chronic damage detected in adults. This condition presents as the higher occurrence of glomerular proliferation and hypercellularity, inflammatory conditions, and acute kidney injury at the outset of the disease in children versus adult population. Additionally, the response to steroid treatment is significantly better in children than adults.

Please cite this paper as: Zandifar S, Khayyat A, Zahmatkesh A, Esmaeil pour MA. Comparative histological and clinical differences between children and adults in IgA nephropathy. J Nephropharmacol. 2024;13(2):e12705. DOI: 10.34172/npj.2024.12705.

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