IgA腎症。IgAメサンギウム腎症
WordNet
- the 9th letter of the Roman alphabet (同)i
PrepTutorEJDIC
- 『私は』私が
- iodineの化学記号
UpToDate Contents
全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.
- 1. IgA腎症：病因iga nephropathy pathogenesis [show details]
… gene polymorphisms in IgA nephropathy with normal "healthy" populations. It raises an important consideration for the pathogenesis of IgA nephropathy: The process of mesangial IgA deposition is likely …
- 2. Overview of kidney disease associated with hepatitis C virus infectionoverview of kidney disease associated with hepatitis c virus infection [show details]
…classified as membranoproliferative glomerulonephritis (MPGN) in 12, immunoglobulin A (IgA) nephropathy in 7, and mesangial glomerulonephritis in 6 patients. A clinical kidney abnormality (elevated serum creatinine …
- 3. IgA腎症：臨床的特徴および診断iga nephropathy clinical features and diagnosis [show details]
… (with mesangial IgA deposits and mesangial cell proliferation characteristic of IgA nephropathy) and proteinuria (with prominent IgG subepithelial deposits characteristic of membranous nephropathy). Whether …
- 4. HIV患者における腎臓病の概要overview of kidney disease in patients with hiv [show details]
… including membranous nephropathy, membranoproliferative and mesangial proliferative glomerulonephritis, "lupus-like" proliferative glomerulonephritis, and immunoglobulin A (IgA) nephropathy . In addition, a …
- 5. IgA腎症：治療および予後iga nephropathy treatment and prognosis [show details]
…abnormalities (eg, proteinuria and microscopic hematuria) or clearance of mesangial IgA deposits . Patients with IgA nephropathy (IgAN) who have little or no proteinuria (less than 500 mg/day) have a low …
English Journal
- Membranous Nephropathy With Crescents: A Series of 19 Cases.
- Rodriguez EF1, Nasr SH1, Larsen CP2, Sethi S1, Fidler ME1, Cornell LD3.Author information 1Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.2Nephropathology Associates, Little Rock, AR.3Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN. Electronic address: cornell.lynn@mayo.edu.AbstractBACKGROUND: Membranous nephropathy (MN) with crescents is rare and, in the absence of lupus, usually is associated with anti-glomerular basement membrane (anti-GBM) nephritis or antineutrophil cytoplasmic antibody (ANCA)-positive glomerulonephritis. Only rare cases of crescentic MN without ANCA or anti-GBM have been reported.
- American journal of kidney diseases : the official journal of the National Kidney Foundation.Am J Kidney Dis.2014 Apr 4. pii: S0272-6386(14)00608-8. doi: 10.1053/j.ajkd.2014.02.018. [Epub ahead of print]
- BACKGROUND: Membranous nephropathy (MN) with crescents is rare and, in the absence of lupus, usually is associated with anti-glomerular basement membrane (anti-GBM) nephritis or antineutrophil cytoplasmic antibody (ANCA)-positive glomerulonephritis. Only rare cases of crescentic MN without ANCA or a
- PMID 24709471
- Validation of the Oxford classification of IgA nephropathy in cohorts with different presentations and treatments.
- Coppo R1, Troyanov S2, Bellur S3, Cattran D4, Cook HT5, Feehally J6, Roberts IS3, Morando L, Camilla R, Tesar V, Lunberg S, Gesualdo L, Emma F, Rollino C, Amore A, Praga M, Feriozzi S, Segoloni G, Pani A, Cancarini G, Durlik M, Moggia E, Mazzucco G, Giannakakis C, Honsova E, Sundelin BB, Di Palma AM, Ferrario F, Gutierrez E, Asunis AM, Barratt J, Tardanico R, Perkowska-Ptasinska A; on behalf of the VALIGA study of the ERA-EDTA Immunonephrology Working Group.Collaborators (121)Tesar V, Maixnerova D, Lundberg S, Gesualdo L, Emma F, Fuiano L, Beltrame G, Rollino C, Coppo R, Amore A, Camilla R, Peruzzi L, Praga M, Feriozzi S, Polci R, Segoloni G, Colla L, Pani A, Angioi A, Piras D, Feehally J, Cancarini G, Ravera S, Durlik M, Moggia E, Ballarin J, Giulio S D, Pugliese F, Caliskan Y, Locatelli F, Del VL, Wetzels JF, Peters H, Berg U, Carvalho F, Maggio M, Wiecek A, Ots-Rosenberg M, Magistroni R, Topaloglu R, Bilginer Y, D'Amico M, Stangou M, Giacchino F, Goumenos D, Kalliakmani P, Gerolymos M, Galesic K, Geddes C, Siamopoulos K, Balafa O, Galliani M, Stratta P, Quaglia M, Bergia R, Cravero R, Salvadori M, Cirami L, Fellstrom B, Kloster SH, Ferrario F, Stellato T, Egido J, Martin C, Floege J, Eitner F, Lupo A, Bernich P, Menè P, Morosetti M, van KC, Rabelink T, Reinders ME, Boria GJ, Cusinato S, Benozzi L, Savoldi S, Licata C, Mizerska WM, Martina G, Messuerotti A, Dal CA, Esposito C, Migotto C, Triolo G, Mariano F, Pozzi C, Boero R, Mazzucco G, Giannakakis C, Honsova E, Sundelin B, Di PA, Ferrario F, Gutiérrez E, Asunis AM, Barratt J, Tardanico R, Perkowska-Ptasinska A, Arce TJ, Fortunato M, Ozluk Y, Kilicaslan I, Steenberger E, Soderberg M, da Costa FA, Riispere Z, Furci L, Orhan D, Kipgen D, Casartelli D, Galesic LD, Bertoni E, Cannata OP, Groene HJ, Stoppacciaro A, Bajema I, Bruijn J, Fulladosa OX, Maldyk J, Ioachim E.
- Kidney international.Kidney Int.2014 Apr 2. doi: 10.1038/ki.2014.63. [Epub ahead of print]
- The Oxford Classification of IgA Nephropathy (IgAN) identified mesangial hypercellularity (M), endocapillary proliferation (E), segmental glomerulosclerosis (S), and tubular atrophy/interstitial fibrosis (T) as independent predictors of outcome. Whether it applies to individuals excluded from the or
- PMID 24694989
- Combined immune thrombocytopenic purpura and immunoglobulin A nephropathy: a similar pathophysiologic process?
- Kahraman C1, Emre H, Gulcan E, Bilen Y, Uludag K, Uyanik A, Keleş M.Author information 1Department of Internal Medicine and Nephrology, Dumlupinar University School of Medicine , Kutahya , Turkey .AbstractAbstract IgA nephropathy is one of the most common forms of glomerulopathies. It is an immune complex-mediated glomerulonephritis diagnosed by the presence of mesangial IgA deposits that are often associated with mesangial cell proliferation. The IgG, C3, IgM, or other immunoglobulin light chains may be co-existed with IgA. Its pathogenesis suggested that it is responsible for enhancing the production of proinflammatory cytokines, chemokines, and growth factors. Platelet-derived growth factor (PDGF) has also been implicated as a modulator of disease activity. Immune thrombocytopenic purpura (ITP) is a bleeding disorder caused by thrombocytopenia that is not associated with a systemic disease. Its pathogenesis suggested an autoimmune disease in which IgG is thought to damage megakaryocytes, which are the precursors of platelet cells. Several studies reported that PDGF levels were higher in normal subjects than in patients with ITP. Moreover, ITP is a disease related to the antibody. Thus, our aim is to examine whether a similar pathophysiological relationship exist between ITP and IgAN that may be mediated by PDGF and/or IgG.
- Renal failure.Ren Fail.2014 Apr;36(3):464-5. doi: 10.3109/0886022X.2013.872568. Epub 2014 Jan 23.
- Abstract IgA nephropathy is one of the most common forms of glomerulopathies. It is an immune complex-mediated glomerulonephritis diagnosed by the presence of mesangial IgA deposits that are often associated with mesangial cell proliferation. The IgG, C3, IgM, or other immunoglobulin light chains ma
- PMID 24456575
Japanese Journal
- Influence of Estrogen on the Progression of Kidney Injury in Murine IgA Nephropathy
★リンクテーブル★
[★]
- 英
- IgA nephropathy, immunoglobulin A nephrophathy
- 同
- IgAメサンギウム腎症 IgA mesangial nephropathy、免疫グロブリンA腎症 イムノグロブリンA腎症 immunoglobulin A nephropathy、IgA腎炎 IgA nephritis、IgA糸球体腎炎 IgA glomerulonephritis、Berger's disease、バージャー病 ベルガー病 ベルジェ病 Berger's disease Berger disease Berger病 Berger nephropathy
- 関
- 一次性糸球体疾患。
[show details]
- first aid step1 2006 p.385(Glomerular pathology)
定義
- → 同様の症状を示す、紫斑病性腎炎(Henoch-Schonlein purpura)、肝硬変、肺疾患とは区別する！！
疫学
- 日本－原発性糸球体腎炎の50-70％ (約40%とする文献もある)。フランス－原発性糸球体腎炎の約20％
- 発症年齢：小児から成人まで認められる。20歳代に好発。男性が若干多い(男女比 3-6：1)
- 若年の新規透析患者の原因(約40%)として重要である。 → 透析導入原疾患の第2位
- 慢性糸球体腎炎のなかで最多(約半数)。
病因
- 免疫複合体型腎炎
- IgAを含む免疫複合体が糸球体に沈着し → 補体を活性化 → 腎炎
- 抗原：細菌、ウイルス、食物蛋白など
- begin as an episode of gross hematuria that occurs within 1 or 2 days of a nonspecific upper respiratory tract infection
病態
- 抗原と結合したIgAからなる免疫複合体が糸球体内皮下とメサンギウム領域に蓄積し腎炎像がみられる。(PRE.245) → 炎症により部分的に糸球体が破綻し血尿をきたす？
- 糸球体腎炎症状が主であって、蛋白尿は軽度。ネフローゼに至ることは稀
病理
- メサンギウム増殖性糸球体腎炎の像が見られる。
- 光学顕微鏡：メサンギウム増殖
- 蛍光顕微鏡：IgAが顆粒状にメサンギウムに沈着。C3, IgG, IgMの沈着が見られることがある
[show details]
メサンギウムにIgAが沈着する疾患
検査
- 蛋白尿は血尿に比べ軽度 ← ネフローゼ優位ではない？
診断
鑑別診断
治療
- 参考2
- 1. ACE阻害薬、アンジオテンシン受容体阻害薬
- 2. 糖質コルチコイド
- 3. 免疫抑制薬
- SPE.596
- 組織障害が軽い例：抗血小板薬、柴苓湯、ACE阻害薬、ARB
- 組織障害が強い例：副腎皮質ステロイド、抗凝固薬、抗血小板薬、免疫抑制薬の組み合わせ。
予後
- 著明な蛋白尿や腎機能低下をきたさない患者は完全に寛解するかもしれないが、ほとんどの患者ではゆっくり着実に進行する。
- 蛋白尿の持続 ± 高血圧 ± 血清Crの上昇 を下している患者は20年の経過で20-30%が末期腎不全に陥り、そのほかの20%は腎機能が低下する。
- 予後不良の腎組織像は、(稀)半月体の形成、糸球体の瘢痕化、尿細管質の萎縮、および間質の線維化である。
予後予測因子
- YN.E-43
- 血圧＞160/95 mmHg、血清Cr＞1.5 mg/dL、Ccr＜50、尿蛋白＞2g/日
予後不良因子
- 蛋白尿の持続、高血圧、高血清Cr、血清蛋白低値、高度な腎組織障害
参考
- http://www.jsn.or.jp/jsn_new/iryou/free/kousei/pdf/44_7.pdf
- 2. [charged] Treatment and prognosis of IgA nephropathy - uptodate [1]
国試
[show details]
[★]
- 英
- immunoglobulin A
- 同
- 免疫グロブリンA γA gamma A
- 関
- 免疫グロブリン Ig
概念
基準値
- 110-410 mg/dl (臨床検査法提要第32版)
臨床関連
[★]
[★]
- 関
- glomerular mesangium、mesangium
[★]
免疫グロブリン immunoglobulin