What is the role of immunofluorescence in the diagnosis of immunoglobulin A (IgA) nephropathy?

Updated: Feb 15, 2018
  • Author: Sohail Abdul Salim, MD, FASN, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Immunofluorescence findings are the pathologic hallmark of this disease. IgA is deposited in a diffuse granular pattern in the mesangium (as seen in the image below) and occasionally in the capillary wall. The deposits are predominantly polymeric IgA of the IgA1 subclass; in addition, IgG is found in 43% of cases, and IgM in 54%. [10] C3 is often present. Polyclonal deposits, often with more lambda than kappa light chains, are seen. Presence of C4d indicates a worse prognosis.

Immunofluorescence microscopy demonstrating large Immunofluorescence microscopy demonstrating large mesangial immunoglobulin A (IgA) deposits diagnostic of IgA nephropathy.

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