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  Table of Contents  
AUTHOR REPLY
Year : 2014  |  Volume : 24  |  Issue : 4  |  Page : 264
 

Author response on: Malignant hypertension and nephrotic range proteinuria without hematuria: IgA nephropathy


1 Department of Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
2 Department of Nephrology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
3 Department of Medicine, Rheumatology and Clinical Immunology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India

Date of Web Publication23-Dec-2013

Correspondence Address:
S Mondal
Doctor's Hostel, 242 A.J.C. Bose Road, Kolkata - 700 020, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-4065.133048

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How to cite this article:
Goswami R P, Sinha D, Mondal S, Mandal S, Ete T, Nag A, Pal J, Chowdhury A R, Ghosh A. Author response on: Malignant hypertension and nephrotic range proteinuria without hematuria: IgA nephropathy. Indian J Nephrol 2014;24:264

How to cite this URL:
Goswami R P, Sinha D, Mondal S, Mandal S, Ete T, Nag A, Pal J, Chowdhury A R, Ghosh A. Author response on: Malignant hypertension and nephrotic range proteinuria without hematuria: IgA nephropathy. Indian J Nephrol [serial online] 2014 [cited 2021 Sep 17];24:264. Available from: https://www.indianjnephrol.org/text.asp?2014/24/4/264/133048


Sir,

We appreciate the reference based comments of Dr. Nasri and thank him for his interest in our article. [1] The association of thrombotic microangiopathy (TMA) with IgA nephropathy, especially in patients with uncontrolled hypertension has been reflected in various studies. A study by Chang et al. found TMA in 10 patients with IgA nephropathy but three patients had only ultrastructural features of TMA. [2] Hence it is possible that TMA may be overlooked by light microscopy. Some patient may have near normal renal histology in the face of TMA. [3] Significant proteinuria, as seen in our patient is also strongly associated with TMA. However in our patient, there was no histological evidence of TMA. The renal Doppler study was also normal. [4] A study by Platt showed a significantly higher resistive index in nephropathies with tubulo-interstitial and/or vascular injury. [5] Due to lack of histological and Doppler evidence we could not comment about TMA in our patient. Though the significance of TMA as an etiological factor of hypertension in IgA nephropathy has been poorly understood, this finding should be actively searched for especially in patients with similar clinical phenotype.

 
  References Top

1.Goswami RP, Sinha D, Mondal S, Mandal S, Ete T, Nag A, et al. Malignant hypertension and nephrotic range proteinuria without hematuria: IgA nephropathy. Indian J Nephrol 2013;23:390-2.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Chang A, Kowalewska J, Smith KD, Nicosia RF, Alpers CE. A clinicopathologic study of thrombotic microangiopathy in the setting of IgA nephropathy. Clin Nephrol 2006;66:397-404.  Back to cited text no. 2
    
3.El Karoui K, Hill GS, Karras A, Jacquot C, Moulonguet L, Kourilsky O, et al. A clinicopathologic study of thrombotic microangiopathy in IgA nephropathy. J Am Soc Nephrol 2012;23:137-48.  Back to cited text no. 3
    
4.Bertolotto M, Quaia E, Rimondini A, Lubin E, Pozzi Mucelli R. Current role of color Doppler ultrasound in acute renal failure. Radiol Med 2001;102:340-7.  Back to cited text no. 4
    
5.Platt JF. Duplex Doppler evaluation of native kidney dysfunction: Obstructive and nonobstructive disease. AJR Am J Roentgenol 1992;158:1035-42.  Back to cited text no. 5
    




 

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