IgA nephropathy associated with thalassemia: a case report

BMC Nephrol. 2020 May 14;21(1):182. doi: 10.1186/s12882-020-01844-3.

Abstract

Background: Thalassemia is a group of hereditary diseases characterized by a common recessive monogenic hematological disorder, presenting a significant public health concern in the developing countries. Recent studies have identified the renal effects of thalassemia syndrome. Chronic hypoxia, long-term anemia, iron overload, and iron chelators are the major causes of renal tubular dysfunction and glomerular filtration abnormalities, while glomerulonephritis is not considered a major cause of abnormal urinalysis.

Case presentation: We report a case of a 38-year-old female patient with immunoglobulin A (IgA) nephropathy accompanied by anemia who was misdiagnosed initially, but was diagnosed with alpha-thalassemia after gene tests. We administered a combination of oral prednisolone, leflunomide, and angiotensin receptor blockers as well as folic acid and mecobalamin. During the follow-up, her proteinuria was significantly reduced, and her anemia was improved.

Conclusions: The possibility of occurrence of thalassemia should be considered in IgA nephropathy complicated with refractory anemia, especially in high-incidence areas of the disease.

Keywords: IgA nephropathy; Renal complications; α-Thalassemia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Angiotensin Receptor Antagonists / therapeutic use
  • Female
  • Folic Acid / therapeutic use
  • Glomerulonephritis, IGA / complications
  • Glomerulonephritis, IGA / diagnosis*
  • Glomerulonephritis, IGA / drug therapy
  • Glucocorticoids / therapeutic use
  • Hematinics / therapeutic use*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Leflunomide / therapeutic use
  • Prednisolone / therapeutic use
  • Vitamin B 12 / analogs & derivatives
  • Vitamin B 12 / therapeutic use
  • alpha-Thalassemia / complications
  • alpha-Thalassemia / diagnosis*
  • alpha-Thalassemia / drug therapy

Substances

  • Angiotensin Receptor Antagonists
  • Glucocorticoids
  • Hematinics
  • Immunosuppressive Agents
  • Folic Acid
  • Prednisolone
  • mecobalamin
  • Leflunomide
  • Vitamin B 12