Clinico-Pathological Characteristics of Children with IgA Nephropathyin a Tertiary-Level Hospital

Abstract

Background: IgA nephropathy (IgAN) is the most common primary glomerulonephritis in children, characterized by mesangial IgA deposition and variable clinical severity of the disease. Limited data from developing countries like Bangladesh, highlight the need to understand their clinicopathological patterns for early diagnosis and prognosis. This study aimed to describe the clinical and histopathological characteristics of Paediatric IgAN using the Oxford MEST-C classification.
Methods: A cross-sectional observational study was conducted at the Department of Paediatric Nephrology, Bangladesh Medical University (BMU), Dhaka, Bangladesh, from May 2024 to April 2025. Thirty-five children (< 18 years) with biopsy-proven IgAN were included in the study. Clinical and laboratory data were recorded at presentation and renal biopsies were analyzed according to the Oxford MEST-C criteria. Data were analyzed using SPSS v25.0.
Results: The mean age was 10.61 ± 3.78 years; 42.9% were 6–10 years and 51.4% were 11–18 years. Proteinuria (54.3%), hematuria (42.9%) and edema (40.0%) were the predominant clinical findings, whereas 17.1% of patients had hypertension and 11.4% required dialysis. The median serum creatinine level was 0.63 mg/dL (IQR 0.355–0.84). Histopathology revealed M1 in 57.1%, E1 in 25.7%, S1 in 34.3%, T1/T2 in 8.6% and crescents in 11.4% of the cases.
Conclusion: Paediatric IgAN in Bangladesh predominantly affects school-aged children and commonly exhibits mesangial hypercellularity and segmental sclerosis. The Oxford MEST-C classification provides valuable prognostic insights, emphasizing the need for early biopsy evaluation and tailored management strategies to improve long-term outcomes.

J Shaheed Suhrawardy Med Coll 2025; 17(1): 46-50