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Old 11-08-2012
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Kidney IgA nephropathy; Should we Biopsy!

patient presents with Nephritis. sore throat 2 days ago. complement normal. you think it is IgA nephropathy. what is next step ?
  • observe
  • biopsy

in mtb3, conrad says bx is must in every case. is it ? dont we just presume and observe\treat ?

Last edited by tyagee; 11-08-2012 at 07:01 AM.
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Old 11-08-2012
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It also says that in MTB 2, mmm I would biopsy just to be sure, you prob would want to biopsy to be absolutely sure the patient has IgA nephropahy... Im not 100 % sure tho.
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Old 11-08-2012
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You always biopsy if you suspect IgA Nephropathy since it is a serious disease with 20% progression to ESRD.

You observe/ treat PSGN without biposy since it is self limited disease and only biopsy if no/little improvement.
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Old 11-08-2012
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Also, you always biopsy an adult presenting with Nephrotic syndrome.
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Old 12-07-2016
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No, you do NOT always biopsy. Patients with isolated microscopic hematuria have an excellent prognosis and should NOT be biopsied.

It is unfortunate that UpToDate is so expensive, but it would really help students when they come across a difficult topic such as this. But whatever you do, please do not rely on MTB or kaplan. If you are unsure, look up the correct answer with UpToDate, BMJ Best Practice, or emedicine (free).
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