Nefropatía por IgA y terapéutica progresiva. Reporte de caso

Gerardo Gilberto Azúa Díaz; Aída Valencia Echeverría; Manuel Valencia Echeverría; Silvia Valencia Echeverría

doi:10.33064/59lm20257510

Authors

Gerardo Gilberto Azúa Díaz Universidad Autónoma de Aguascalientes https://orcid.org/0000-0002-8065-3487
Aída Valencia Echeverría Universidad Autónoma de Aguascalientes https://orcid.org/0009-0005-2955-7800
Manuel Valencia Echeverría Universidad Nacional Autónoma de México https://orcid.org/0009-0000-5099-3838
Silvia Valencia Echeverría Universidad Autónoma de Zacatecas https://orcid.org/0009-0001-8144-2219

DOI:

https://doi.org/10.33064/59lm20257510

Keywords:

IgA nephropathy, Glomerulonephritis, Hematuria, Proteinuria, Treatment

Abstract

Introduction: IgA nephropathy (IgAN) is the most common primary glomerulopathy worldwide. It is characterized by mesangial deposition of galactose-deficient IgA1 (Gd- IgA1) forming immune complexes that lead to inflammation and progressive glomerular damage. Objective: To present a representative clinical case of IgAN and provide a critical review of therapeutic developments over the past seven years, relating them to the treatment approach used in this patient. Methods: The case of a female patient with recurrent microscopic hematuria was documented. Clinical, laboratory, and histopathological findings are described. A systematic search was conducted for articles on various platforms reporting the therapeutic evolution of IgA nephropathy (IgAN) management. Results: The clinical diagnosis of IgAN was established based on persistent microscopic hematuria without poor prognostic markers. Treatment with renin-angiotensin-aldosterone system (RAAS) inhibitors was initiated, leading to reduced proteinuria and preserved renal function. After two years, the patient experienced a relapse with macroscopic hematuria. A kidney biopsy confirmed mesangial proliferation with IgA deposits. The Oxford MEST-C classification indicated low risk of progression, and the International IgA Progression Tool estimated a 6-year progression risk of 6.42%. Conclusion: IgAN is a heterogeneous disease requiring histological diagnosis and individualized management. Advances in its pathophysiological understanding have led to evolving therapeutic strategies, though not all are applicable to every patient. The disease still.

Recepción: 18/12/2024

Aprobación: 18/12/2024

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