Abstract:Introduction: Most studies of IgM nephropathy have consisted of patients with nephrotic syndrome (NS). However, IgM nephropathy is also associated with hematuria and asymptomatic proteinuria. In the long-term follow-up approximately one-third of the NS patients found to develop renal failure of some degree, half the patients experienced hypertension and some developed focal segmental glomerular sclerosis (FSGS) [1-2].There are only few studies have been reported on the population-based incidence and prevalence, mode of presentation, immunopathological features, pattern of steroid response, and the long-term prognosis of IgM nephropathy in either children or adults.
Objective: To describe the clinical and immunopathological features of IgM nephropathy and its response to steroids and its progression to renal failure.
Method: This is a descriptive, retrospective study carried out in SVIMS and Katuri hospitals, where the clinical records of patients with IgMN were analysed.
Results: From a total number of 2000 renal biopsies, performed during this period, we encountered 45 patients (2.25%) of IgM nephropathy with renal biopsy proof. The number of adults were 35 (77.7%), the number of males were 24 (53.3%). The mean age was 28 years and age range was one year to 64 years; male to female ratio was 1.2:1. The renal syndrome presentation at the first instance was NS in all 45. In addition to NS the other clinical manifestations included hypertension in six, hematuria in eight, and elevated serum creatinine in four patients.
Conclusion: In conclusion, IgM nephropathy is an important cause of NS in both children and adults. It shows a spectrum of morphologic changes ranging from minor changes to FSGS. The diagnosis depends on IF. Although a poor clinical response to steroid therapy distinguished this disease from minimal change disease, in our patients the steroid sensitivity was greater.