Tonsillectomy for IgA Nephropathy?

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IgA Nephropathy is the most common cause of glomerulonephritis globally. It is especially common in Japan, although some of this prevalence may be due to increased screening (all school children undergo a screening urinalysis as part of their normal workup, and as a result many cases of hematuria which normally would go undetected gets worked up). One of the treatments widely used for IgA Nephropathy there is tonsillectomy.

The idea here is that IgA Nephropathy commonly presents with so-called “synpharyngitic glomerulonephritis”–gross or microscopic hematuria, often with transient renal injury, which coincides with the onset of strep throat. Repeated infections can lead to repeated glomerular injury and eventual renal decline; tonsillectomy would be hypothesized to cut down on the number of episodes of pharyngitis and thereby limit the degree of renal damage. We have one patient in our clinic right now we are presently trying to convince to undergo tonsillectomy; we will see if he heeds our advice.

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