IgA Acute Glomerulonephritis Associated with S. Aureus

IgA Acute Glomerulonephritis Associated with S. Aureus

Robert B. Colvin, MD

Glomerulitis may be mild in cases of IgA positive acute glomerulitis associated with Staphylococcus aureus infection. Many mononuclear and a few polymorphonuclear leukocytes are present image.

Acute glomerulonephritis associated with Staphylococcal aureus infection typically has prominent mesangial IgA deposits, which resemble IgA nephropathy or HSP.



  • Acute glomerulonephritis (GN) associated with Staphylococcus aureus infection with predominance of IgA deposition


Infectious Agents

  • S. aureus, coagulase positive, often methicillin resistant (MRSA)

    • Osteomyelitis, pneumonia, septic arthritis, discitis, soft tissue abscess, empyema, sinusitis, endocarditis

    • Septicemia

    • Not usually postinfectious GN but occurs during chronic infection

      • Average duration of infection is 5 weeks

Host Factors

  • Diabetes mellitus, neoplasia, old age, alcoholism

Immune Response

  • IgA antibodies to S. aureus cell membrane antigen (GenBank BAB41819.1)

  • S. aureus enterotoxins may act as superantigens, stimulating T cells and leading to polyclonal B-cell activation

  • 1 superantigen-like protein (SSL7) binds to Fc of IgA, blocking FcR activity



  • Persistent infection, septicemia

  • Acute renal failure

  • Hematuria

  • Proteinuria, nephrotic range (20-80%)

  • Hypertension

  • Hypocomplementemia (minority)

  • Purpura


  • Antibiotics and renal support

  • Anecdotal reports of steroids/immunosuppression


  • Data limited

    • Range of outcomes from complete recovery to ESRD

    • Recovery possible if infection successfully treated

  • Underlying disease and age are important factors


  • ˜ 25% of renal biopsies with acute postinfectious glomerulonephritis


Jul 7, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on IgA Acute Glomerulonephritis Associated with S. Aureus
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