Crescentic IgA nephropathy following bone fracture

Abstract

Immunoglobulin A (IgA) nephropathy is the commonest form of primary glomerulonephritis with variable clinical presentation. It has been associated with several infectious and non-infectious diseases but with only few reported cases following traumatic bone fracture. The present case report describes a 55 years old male patient who developed acute kidney injury within 3 months following bone fracture. Urine examination showed microscopic haematuria and proteinuria together with rapid deterioration in renal function. Light microscopic examination of kidney biopsy sections showed glomerular mesangial proliferation with fibro-cellular crescent formation in few glomeruli, two glomeruli were sclerosed, in addition to interstitial inflammation and tubular atrophy. Immunofluorescence microscopy showed mesangial IgA and C3 deposits. The renal function improved substantially following a course of steroids and mycophenolate mofetil without dialysis support. The development of acute IgA nephropathy is possibly followed the incident of traumatic bone fracture.