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J Nephropathol. 2013 Apr;2(2):98-103. doi: 10.12860/JNP.2013.16. Epub 2013 Apr 1.

IgM nephropathy; can we still ignore it.

Author information

1
Department of Pathology, Laboratory Medicine and Transfusion Services and Department of Immunohematology, GR Doshi and KM Mehta Institute of Kidney Diseases & Research Centre, Gujarat, India.

Abstract

CONTEXT:

IgM nephropathy (IgMN) is a relatively less recognized clinico-immunopathological entity in the domain of glomerulonephritis , often thought to be a bridge between minimal change disease and focal segmental glomerulosclerosis.

EVIDENCE ACQUISITIONS:

Directory of Open Access Journals (DOAJ), Google Scholar, Pubmed (NLM), LISTA (EBSCO) and Web of Science has been searched.

RESULTS:

IgM nephropathy can present as nephritic syndrome or less commonly with subnephrotic proteinuria or rarely hematuria. About 30% patients respond to steroids whereas others are steroid dependent / resistant. They should be given a trial of Rituximab or stem cell therapy.

CONCLUSIONS:

IgM nephropathy (IgMN) is an important and rather neglected pathology responsible for renal morbidity in children and adults in developing countries as compared to developed nations with incidence of 2-18.5% of native biopsies. Abnormal T-cell function with hyperfunctioning suppressor T-cells are believed to be responsible for this disease entity. Approximately one third of the patients are steroid responders where as the remaining two thirds are steroid resistant or dependent. Therapeutic trials including cell therapies targeting suppressor T-cells are required.

KEYWORDS:

Focal segmental glomerulosclerosis; Hypertension; IgM nephropathy; Minimal change disease; Proteinuria

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