September 1976

Mesangial IgA Immunofluorescence in Idiopathic Renal Hematuria-Reply

Arch Intern Med. 1976;136(9):1067. doi:10.1001/archinte.1976.03630090089023

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In Reply.—  Drs McVicar, Nicastri, and Friedman report in their letter that three of 13 patients with the clinical syndrome of idiopathic hematuria whose renal biopsy specimens had predominantly mesangial deposition of IgA developed severe impairment of renal function after a follow-up period of 8 to 18 years. They suggest that idiopathic hematuria is not always a favorable condition. I have no objections to this conclusion. Indeed, four of the 80 patients that we reported had a creatinine clearance of less than 80 ml/min. Roy et al (J Pediatr 82:767-772, 1973) was able to identify a group of young patients with idiopathic hematuria with deteriorating renal function, including hypertension, whose renal biopsy specimens showed segmental glomerular sclerosis with positive mesangial immunofluorescence. I am hopeful that more careful and extended follow-up of these patients for many decades will allow the determination of those histopathological and immunopathological findings that may serve to

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