FAMILIAL IgA NEPHROPATHY: A STUDY OF RENAL DISEASE IN AN AUSTRALIAN ABORIGINAL FAMILY

Abstract

An Australian Aboriginal family, extending four generations, with a high incidence of renal disease was investigated. Twenty-eight of 114 members screened had hematuria. Of those tested, five had hypertension, four maturity onset diabetes, one a raised serum creatinine concentration, five elevated serum IgA levels and two cortical scarring on intravenous pyelogram. Of the eight members who underwent renal biopsy, five had IgA nephropathy and one had light and electron microscopy evidence of glomerulonephritis, but no IgA was seen on immunofluorescence. One had mild nonspecific changes by light microscopy but no immunofluorescence or electron microscopy was available and the remaining patient had mild changes consistent with hypertension and diabetes. HLA typing, carried out for 27 family members, showed an increased incidence of HLA-B22, B27, B39, and DR1 when compared to Yuendumu Aborigines (B27 and DR1), or Australian Caucasians (B22), or both (B39). This may be due to an association with IgA nephropathy, or a family clustering of antigens. Overall, this study suggests a genetic mechanism in the pathogenesis of IgA nephropathy in some patients and, as there was evidence of renal disease in 25% of those tested, may indicate an underlying high incidence of renal disease in the Aboriginal community.

Primary IgA nephropathy in north India: is it different?

“…The bulk of the disease burden is borne by Asians and whites, as compared to blacks from the USA and South Africa 4 5. In addition, Polynesians from New Zealand6 have a low frequency of the condition, whereas native Americans from New Mexico7 and Australian aborigines8 have a high frequency. The incidence quoted in the literature in France,9 Germany,10 and Italy11 varies from 15 to 40 new cases per million population per year.…”

Glomérulonéphrite à dépôts mésangiaux d’immunoglobulines A

“…La né phropathie à IgA semble plus fré quente chez les patients caucasiens et asiatiques que chez les patients noirs. Il existe né anmoins des disparité s : sa fré quence est en effet trè s basse chez les polyné siens de Nouvelle-Zé lande, et trè s é levé e chez les aborigè nes d'Australie ou les indiens du Nouveau-Mexique [7][8][9].…”

Clinical Heterogeneity in Familial IgA Nephropathy

“…There is an increased incidence among Caucasians and Asians when compared to African and Hispanic ancestry [17-19], and differences in prevalence between separate racial groups within specific geographical regions have also been noted. For example, in Australia and North America, a higher prevalence has been noted among Australian aborigines [20] and Native Americans [21-23], respectively, when compared to their Caucasian compatriots. Similar differences in prevalence between distinct racial groups have also been observed in New Zealand [24].…”