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IgA Nephropathy, Hematuria, Persisting Idiopathic Edema

Posted on Fri, 28 Sep 2012

Question: Hi, my name is XXXXXXX I have a condition called IgA Nephropathy. It is a form of glomunepharitis which affects the kidneys. What I would like to know is the following: I had the following symptoms in 1999, 2000, 2001 and 2003 - blood in my urine (hematuria) and lower leg and calf edema. I went to see my GP several times and was sent to an internist in 2001. The internist diagnosed me with idiopathic edema in 2001 with no further testing other than what was in my medical file. I finally went to a new GP in 2004 when I moved and explained everyhitng that had been going on and begged for a full work-up. That is when hematuria, and protien were found in my urine while I still had the edema. What I would like to know is if the testing had been pursued in 2001, would it be safe to say that the disease would have been found sooner? I am searching for answers for my own peace of mind at this time. Thank you.

Answered by Dr. Dilip M Babu (45 hours later)

Hi,

Thanks for posting your query.

I have gone through your case history.

Diagnosis of idiopathic edema will be made only after ruling out other causes of edema.

We have to do all the investigations [like urine protein,complement levels] to rule out glomerulonephritis. Such patients will require kidney biopsy to find out reason and outcome of glomerulonephritis like IgA nephopathy.

I would like to know your blood pressure,exact level of proteinuria, creatinine level [eGFR] to tell you the outcome of disease. Outcome and progress of IgA nephropathy will depend on above mentioned parameters.

Hope I have answered your query adequately. Should there be any more queries, I will be available address them.

Regards

Dr Dilip M Babu
.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dilip M Babu (4 hours later)

So in 2001, further testing should have been done in order to determine what was the cause of the swelling in the fett, ankles and calfs. If there was no further testing completed then a diagnosis of idiopathic edema should not have been the diagnosis, would that be correct?

Answered by Dr. Dilip M Babu (19 hours later)

Hi,
I think complete testing like urine protein,creatinine[eGFR] should have been done in 2001 to rule out kidney disease as cause of leg swelling.Without testing we will not keep the diagnosis of idiopathic edema as it is the diagnosis of exclusion.

Regards
Dr Dilip M Babu

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dilip M Babu (1 hour later)

There is currently a wide array of research that links nephritis (like IgA, which is consider an autoimmune disease) with an environmental trigger such as asbestos exposure or diesel fumes or other environmental factor. Is there any basis to this research?

Answered by Dr. Dilip M Babu (2 days later)

Hi,
Thanks for the query.

Etiology of IgA nephropathy is unknown.

Genetic predisposition-familial incidence has been described in United States [in eastern kentucky].

Cytomegalovirus,Hemophilus parainfluenzae,Staphylococcus aureus and Toxoplasmosis have been implicated in etiology of IgA Nephropathy.

Hypersensitivity to food antigens is also related to etiology of IgA Nephropathy.

IgA nephropathy results from dysregulation of mucosal-type IgA immune response.

Environmental factors are not related to IgA nephropathy.

Wishing you good health.

Thanks
Regards

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Above answer was peer-reviewed by : Dr. Radhika