What are the MHLW/JSN guidelines grade C1 recommendations for treatment of immunoglobulin A (IgA) neuropathy?

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

The following treatment options may be considered, but only weak evidence supports these recommendations (grade C1) [9] :

  • ACEI or ARB therapy to reduce proteinuria in patients with urinary protein level of 0.5–1.0 g/day
  • Steroid therapy to reduce proteinuria in patients with urinary protein level of 0.5–1.0 g/day and CKD stage G1-2
  • Tonsillectomy alone or combined with steroid pulse therapy to improve urinary findings and lower the progression of renal dysfunction
  • Off-label use of cyclophosphamide, azathioprine, cyclosporine, mycophenolate mofetil, and mizoribine to improve the renal prognosis
  • Antiplatelet agents: dipyridamole to reduce proteinuria and control the progression of renal dysfunction; dilazep to reduce proteinuria
  • Fish oil to improve the renal prognosis

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