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Hey guys, I was reading up on Nephritic Glomerular dz's in Rapid Review path and for IgA glomerulopathy (Berger's dz) i noticed it says its due to: "Increased mucosal synthesis and DECREASED CLEARANCE OF IgA; INCREASED SERUM IgA"

when I looked up IgA glomerulopathy in First Aid 2010, it's says its due to "INCREASED SYNTHESIS OF IgA"

... i'm confused... is IgA synthesis increased b/c the IgA is getting trapped in the mesangial cells of the kidney which are then being destroyed by anti-bodies, hence decreased clearance????
 

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Neither Nor

The pathophysiology of Berger disease is not yet completely understood. Statistics has shown that over 50% of the patients have elevated IgA levels but could not be attributed to causation because the reverse is not true, i.e. not all persons with high IgA levels (e.g. AIDS patients) will develop IgA nephropathy.

So neither increased synthesis nor decreased clearance should be construed as a principle concept in the pathophysiology and you are not going to be asked about it in the USMLE Exam.

References:
Medscape
UpToDate
Harrison's
 
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