“Juliano Tanakashi, 23 anos, estudante de medicina, comparec...

Doenca de berger

Aumento de iga. Funcao renal presermada. Hematuria. Associacao com hiv ivas cirrose

Nao tem cura tem controle 

A history suggestive of preceding streptococcal infection may include a preceding infective episode such as pharyngitis, tonsillitis, or pyoderma. This is the sine qua non for the diagnosis of acute poststreptococcal glomerulonephritis (APSGN). A latent period always occurs between the streptococcal infection and the onset of signs and symptoms of acute glomerulonephritis. In general, the latent period is 1-2 weeks after a throat infection and 3-6 weeks after a skin infection. [12] The onset of signs and symptoms at the same time as pharyngitis (also called synpharyngitic nephritis) is more likely to be immunoglobulin A (IgA) nephropathy rather than APSGN.

IgA nephropathy was first described by Berger and Hinglais in 1968, and is also known as Berger disease. 

Symptomatic presentations in patients with IgA nephropathy include the following:
Episodic gross hematuria
Rapidly progressive glomerulonephritis –  This is sometimes seen as a late presentation; these patients  may progress to needing renal replacement therapy rapidly.
Nephrotic syndrome – More than 3.5 gms of proteinuria with edema, hypoalbuminemia, hypertension, and hyperlipidemia.
Chronic renal failure 

The treatment of IgA nephropathy in any individual patient should be tailored to that patient's presentation, given the conflicting results of many studies of this disease. All patients should be given supportive therapy with renin-angiotensin system blockade and dietary sodium restriction.Tonsillectomy is appropriate only for patients with recurrent tonsillar infections. Control of proteinuria is prudent, since there is a mostly linear association between the severity of proteinuria and decline in estimated glomerular filtration rate (GFR). Use of Immunosuppression should be determined by considering the rate of progression, comorbidities, and whether alarming features are present on biopsy. Currently, corticosteroids are the option with the most convincing evidence to support their use; however, steroids preferably should not be given for more than 6 months.

IgA nephropathy is more common in Asians and whites and is rare in blacks, both in the United States and in Africa. The condition is frequently observed in Native Americans of the Zuni and Navajo tribes.IgA nephropathy is more common in males than in females. Virtually all studies show a male predominance of at least 2:1, with reported ratios of up to 6:1. [11] The higher male predilection is observed in white patients in northern Europe and the United States.IgA nephropathy can affect all ages but is most common in the second and third decades of life. Eighty percent of patients are aged 16-35 years at the time of diagnosis. The condition is uncommon in children younger than 10 years.

(Fonte: Medscape.com)