Berger’s disease, commonly known as Ig A Neuropathy (short for Immunoglobulin A), is a kidney disease, which affects the glomerulus. Glomeruli are the tiny blood filters where urine is made.
In this condition, IgA settles in the kidney and causes scarring and inflammation within the kidney, which can only be seen clearly under the microscope. Therefore it is normally only diagnosed after a biopsy test of the kidney. What is seen under the microscope is that the “glomeruli”, which are the tiny structures which filter the blood to make urine, are damaged by deposits of IgA.
After diabetes and high blood pressure, IgA nephropathy is the third leading cause of chronic kidney disease (CKD) in the United States.
Antibodies are produced when there is a virus, bacterium or toxin, threatening the body. Normally, these antibodies will help fight the thing that is invading the body. For reasons that are unknown, IgA can get into the kidney, causing inflammation. This condition can eventually lead to blood and protein in the urine, high blood pressure, swollen hands and feet and other signs of CKD.
Berger’s disease usually progresses slowly over many years, but the course of the disease in each person is uncertain. Some people leak blood in their urine without developing problems, some eventually achieve complete remission, and others develop end-stage kidney failure.
Causes
The disease seems to cluster in certain families and in certain areas of the world. It rarely occurs in people of African heritage. These facts suggest that genetic influences may play a role in the development of the disease.
IgA is a protein called an antibody that helps the body fight infections. Berger’s disease occurs when too much of this protein is deposited in the kidneys. IgA builds up inside the small blood vessels of the kidney. Structures in the kidney called glomeruli become inflamed and damaged. Berger’s disease is a form of mesangial proliferative nephritis.
The disorder can appear suddenly (acute), or get worse slowly over many years (chronic glomerulonephritis).
Who is at Risk?
Factors that increase may your chance of IgA nephropathy include –
gastrointestinal such as cirrhosis, celiac disease, inflammatory bowel disease infectious disease such as HIV, tuberculosis, hepatitis pulmonary disease such as bronchiolitis obliterans, small cell lung cancer lymphoma dermatitis herpetiformis seronegative arthritis.
- Family history
- Gastrointestinal disorders, such as inflammatory bowel disease or celiac disease
- Cirrhosis of the liver
- Henoch schoenlein purpura
Symptoms
Symptoms for IgA nephropathy don’t occur at the beginning stages of the disease. Instead, it’s a progressive condition that can take decades to produce symptoms. Sometimes, during a routine screening your doctor may detect signs of IgA nephropathy, which include: –
- Cola or tea-colored urine, due to blood in the urine (hematuria)
- Periodic pain in the loins, abdomen, sides or flanks
- Foam after urination caused by protein in the urine (known as proteinuria)
- Fatigue
- Flu and cold-like symptoms
- High blood pressure
- Swelling of the hands and feet (edema)
- Mood swings
- Becoming more susceptible to allergies
- Lack of response to cold temperatures (mainly in children)
- Urinary tract infections (UTIs, mainly in young girls)
Treatment
Medications
Depending on the symptoms and overall health –
- Medications to help control blood pressure and decrease protein loss in the urine
- Cholesterol lowering medication
- Corticosteroids to decrease inflammation in the body
- Medications to suppress the immune system
Surgery
Dialysis takes over the job of the kidneys if they are not able to work well. It cannot cure the kidney damage, but it will help you feel better and decrease symptoms like high blood pressure.
A kidney transplant may be needed when illness has progressed and the kidneys have failed.
Lifestyle Changes
- Exercise can help with overall health. It can also help manage cholesterol and blood pressure.
- Don’t smoke
Alternative Treatment
Vitamins – Vitamin C can strengthen the immune system so as to help fight against aliments such as cold and infection. These aliments may cause blood urine and speed up kidney failure for Berger’s patients. IgA Nephropathy patients may also need vitamin D, vitamin E, vitamin K and some other vitamins
Low-antigen diet – A low-antigen diet, which consists of restricting dietary gluten and avoiding meats and dairy products, has been recommended to decrease mucosal antigen exposure.
Low-protein diets have been recommended to slow the rate of progression of many nephropathies.
Omega-3 fish oil provides essential fatty acids that cannot be made by our bodies but must be supplied by our diet. These include linoleic and linolenic acids, which are found in black currant, borage, primrose and flax oils as well as fish, EPA (eicosapentaenoic acid), and DHA (docosahexanenoic acid). Omega-3 fatty acids affect the production of eicosanoids, cytokines, and thromboxane A2, all of which are believed to have a role in injuring the glomeruli.
Blueberry contains antioxidant phytonutrients and manganese, which can keep the bones healthy.
Vitamin D – Deficiency of vitamin D is present early in the course of CKD, and correction may prevent activation of key pathogenic mechanisms in cardiovascular disease (eg, inflammation, myocardial cell hypertrophy and proliferation, and the renin-angiotensin system).
Reference
http://www.nejm.org/doi/pdf/10.1056/NEJMra1206793
http://cjasn.asnjournals.org/content/2/5/1054.long
https://www.med.nyu.edu/medicine/nephrology/sites/default/files/nephrology/IGA%20Nephropathy.pdf
http://jasn.asnjournals.org/content/16/7/2088.full.pdf
http://www.worldscientific.com/worldscibooks/10.1142/7064
http://bestpractice.bmj.com/best-practice/monograph/480.html