Involvement of tonsils in IgA nephropathy

Abstract

This study was intended to clarify the involvement of tonsils in the pathogenesis of IgA nephropathy. In 62 patients with IgA nephropathy and 20 patients with other renal diseases, their tonsils were stimulated by an ultra short wave. Forty of 62 patients with IgA nephropathy (65%) showed a deterioration of urinary findings after the stimulation compared with six of 20 patients with other renal diseases (30%). Previous episodes of gross hematuria following upper respiratory tract infections existed in 17 of 40 patients (Group A) who showed a deterioration of urinary findings after tonsil stimulation (43%) as against in four of 22 (Group B) without the deterioration (18%). The level of serum secretory IgA was higher in Group A than in Group B. It is suggested that chronic tonsillitis may play an important role in the development of IgA nephropathy. Thirty-six patients received tonsillectomy from 1980–2002. The frequency of gross hematuria at upper respiratory infection decreased in 56% of the patients. The amount of urinary protein decreased in 33% of the patients and RBC counts decreased in 56% of the patients. Eight patients with tonsillectomy were followed up longer than 16 years. Two of them went to hemodialysis and five of them showed no urinary abnormalities at present. The effect of tonsillectomy in the long term was not clarified in this study.