P45 ANA positivity in IgA nephropathy: is systemic lupus erythematosus coming up?

Background IgA nephropathy is the most common chronic primary glomerulonephritis, leading to progressive renal failure in at least one third of patients. Although IgA nephropathy is a limited non-systemic renal disease, many systemic diseases are sporadically associated with mesangial IgA deposition. Henoch-Schonlein purpura, systemic illness, has been closely linked to IgA nephropathy. Other systemic diseases in which mesangial deposits of IgA are regularly observed include SLE, hepatitis, dermatitis herpetiformis, and ankylosing spondylitis. The occurrence of non-lupus glomerulopathies has been rarely reported in patients with SLE. We report of 11 patients with biopsy-proven IgA nephropathy and ANA positivity. Methods Of all patients with biopsy-proven IgA nephropathy followed in our Unit we selected patients with ANA positivity. Results Of 11 patients with IgA nephropathy and ANA positivity six were females, mean age was 32±11 years. The median follow-up was 7 years (range: 3–38 years). Mean serum creatinine was 1.2±0.75 mg/dl; mean 24h-proteinuria was 1.6±2.3 g/day. In all patients there was low C3. In table 1 are summarized patient characteristics. All patients were on Ace-i or ARB therapy, of these three were treated with steroids, four received steroids+ immunosuppressive drug. Mean follow-up serum creatinine was 1.1±0.7 mg/dl; mean follow-up 24h-proteinuria was 0.4±0.3 g/day. One patient developed SLE. Conclusions Our cohort suggests the hypothesis that IgA nephropathy could be a special subtype of Lupus Nephritis; however it needs more clinical observation and research.