Proliferative glomerular deposits in the kidney are found in
Correct Answer: IgA nephropathy
Description: IgA nephropathy or Berger's disease: immune complex-mediated glomerulonephritis defined by the presence of diffuse mesangial IgA deposits often associated with mesangial hypercellularity. Male preponderance, peak incidence in the second and third decades of life.Clinical and laboratory findings: Two most common presentations recurrent episodes of macroscopic hematuria during or immediately following an upper respiratory infection often accompanied by proteinuria or persistent asymptomatic microscopic hematuriaIgA deposited in the mesangium is typically polymeric and of the IgA1 subclass. IgM, IgG, C3, or immunoglobulin light chains may be codistributed with IgAPresence of elevated serum IgA levels in 20-50% of patients, IgA deposition in skin biopsies in 15-55% of patients, elevated levels of secretory IgA and IgA-fibronectin complexesIgA nephropathy is a benign disease mostly, 5-30% of patients go into a complete remission, with others having hematuria but well preserved renal functionAbout 25-30% of patients have progressive disease and developmental failure slowly over 20-25 yearsPersistent proteinuria for 6 months or longer is found to be associated with adverse renal outcomesLight microscopy may reveal lesions such asDPGN; segmental sclerosis; and rarely, segmental necrosis with the cellular crescent formation, which typically presents as RPGNHenoch-Schonlein purpura is distinguished clinically from IgA nephropathy by prominent systemic symptoms, a younger age (<20 years old), preceding infection, and abdominal complaintsRef: Harrison's 18/e p2342
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