Immunoglobulin A nephropathy: clinical case with source in resistant remission


DOI: https://dx.doi.org/10.18565/therapy.2019.2.123-128

Sigitova O.N., Kim T.Yu.

Kazan State medical University of the Ministry of Healthcare of Russia
The article is about international recommendations (2012) and national clinical guidelines (2016) on the management of patients with immunoglobulin A nephropathy, based on histomorphological diagnosis and assessment of the risk of nephropathy progression depending of proteinuria, hypertension, and kidney function. A clinical case of immunoglobulin A nephropathy is presented using clinical recommendations in actual clinical practice, with an outcome in stable remission. In clinical practice, the management of a patient with immunoglobulin A nephropathy on the basis of clinical recommendations allowed eliminating the secondary nature of nephropathy at the diagnostic stage and, after nephrobiopsy, diagnosing immunoglobulin-A nephropathy; and at the stage of treatment, which gradually included antimicrobial agents, tonsillectomy, blockers of the renin-angiotensin-aldosterone system and prednisone, to achieve stable remission. The use of clinical guidelines for the diagnosis and treatment of immunoglobulin A nephropathy, which consists in eliminating the secondary nature of nephritis, conducting nephrobiopsy using light and immunofluorescence microscopy; and treatment based on an assessment of the risk of progression of nephropathy, allows you to make a diagnosis of immunoglobulin A nephropathy and achieve a stable remission within for four years.
Keywords: resistant remission, immunoglobulin A nephropathy, clinical guidelines, clinical case
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About the Autors

Olga N. Sigitova, MD, professor, Head of the Department of general practice No 1 of Kazan State medical University of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 49 Butlerova Str. Tel./fax: +7 (843) 231-21-39;
tel.: +7 (917) 396-24-17. E-mail: osigit@rambler.ru
TaisiaYu. Kim, assistant professor of the Department of general practice No 1 of Kazan State medical University of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 49 Butlerova Str. Tel./fax: +7 (843) 231-21-39.
E-mail: tais_ariana@mail.ru


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