Intest Res.  2021 Oct;19(4):430-437. 10.5217/ir.2020.00067.

Clinical characteristics of inflammatory bowel disease patients with immunoglobulin A nephropathy

• Hayashi R
• Ueno Y
• Tanaka S
• Onishi K
• Takasago T
• Wakai M
• Naito T
• Sasaki K
• Doi S
• Masaki T
• Chayama K

• KMID: 2521606
• DOI: http://doi.org/10.5217/ir.2020.00067

Abstract

Background/Aims
Inflammatory bowel disease (IBD) is a chronic inflammation of the gastrointestinal tract. Some patients with this condition have been reported to present with immunoglobulin A nephropathy (IgAN), a renal complication that can cause end-stage renal failure, but the frequency of this comorbidity has not been described. Thus, the aim of this study was to investigate the frequency of IgAN in patients with IBD.
Methods
This study included 620 patients with IBD (338 with ulcerative colitis [UC] and 282 with Crohn’s disease [CD]) from the Hiroshima University Hospital outpatient department. IgAN cases were identified from medical interviews, blood examinations (serum immunoglobulin A), and urinalyses (occult blood, proteinuria). Definitive IgAN cases were diagnosed by renal biopsies, while those detected through the clinical course and test results, but not clinically recommended for renal biopsy, were defined as suspected IgAN.
Results
We analyzed 427 cases meeting the inclusion criteria (220 with UC and 207 with CD). The incidence of IgAN across all patients with IBD was 3.0%. The frequency of IgAN was significantly higher in patients with CD (11/207, 5.3%) than in those with UC (2/220, 0.9%) (P< 0.01). Moreover, a significant correlation was found between CD patients with ileostomy or colostomy and a diagnosis of IgAN.
Conclusions
Patients with IBD present a high incidence of IgAN, especially those with CD who have undergone ileostomy or colostomy.

Keyword

Inflammatory bowel disease; Crohn disease; Colitis, ulcerative; Immunoglobulin A nephropathy; Extraintestinal manifestation

Figure

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  Fig. 1. Flow diagram of patients enrolled in this study. IBD, inflammatory bowel disease; UC, ulcerative colitis; CD, Crohn’s disease; IgA, immunogloburin A; IgAN, IgA nephropathy; sIgAN, suspected IgAN; dIgAN, definite IgAN.

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