Berger’s disease- symptoms and treatment

Berger’s Disease

Berger’s disease or IgA nephropathy is the most common glomerulonephritis in adults and is characterized by deposits of IgA antibodies in glomeruli. This disease can occur primary, without a known cause, or it can occur secondary to other conditions such as liver disease, gastrointestinal, cutaneous or respiratory infections. It can be associated with Henoch-Schönlein purpura (HSP), which is characterized by purpuric rash, joint pain and abdominal pain. IgA nephropathy is a disease with a slow evolution towards chronic renal failure with exacerbations during infectious episodes.

Berger’s disease is a kidney disease that occurs due to accumulation of IgA antibodies in glomeruli. It seems that an important role in the onset of the disease is represented by the immune system as it has been found that the Ig A nephropaty can occur after kidney transplantation. Moreover the IgA subclass (Ig A1) which is stored in the kidneys does not come from mucosa associated lymphatic tissue ( MALT) but from the bone marrow. IgA deposition in glomerulus leads to injury, impaired glomerular basement membrane permeability and finally glomerulosclerosis.

Berger’s disease

Symptoms

Usually, the disease is manifested by macroscopic hematuria that occurs after upper respiratory tract infection, gastrointestinal, skin or urinary infection. Hematuria (red blood cells in the urine) may be accompanied by proteinuria (proteins in the urine) that can be nephritic (below 3.5 g / day) or nephrotic (over 3.5 g / day). Macroscopic hematuria may disappear but microscopic hematuria persist and never goes away which is a hallmark of the disease. It can also manifest as acute nephritic syndrome with hematuria, edema and hypertension.

Berger’s disease diagnosis

Symptoms and signs such as recurrent hematuria, accompanied by edema and hypertension, are suggestive of Berger’s disease. Urine exams and blood tests show hematuria, proteinuria, inflammatory syndrome and other abnormalities. But for the diagnosis to be confirmed a renal biopsy is required.

Berger disease treatment

Berger’s disease treatment varies according to the symptoms and the clinical condition of the patient because there are situations when the disease is discovered incidentally (so the patient is asymptomatic) and situations when the patient presents to the physician in acute renal failure or chronic renal failure. Depending on the level of proteinuria there may be administered converting enzyme inhibitors, corticosteroids and immunosuppressants. In addition, studies have shown that long-term treatment with omega-3 fatty acids delays kidney failure. Converting enzyme inhibitors (enalapril, captopril) or angiotensin II receptor blockers (irbesartan, candesartan) lower blood pressure and have the advantage that they have nephroprotective effects because they decrease proteinuria.