IgA dominant post-infectious glomerulonephritis: pathology and insights into disease mechanisms

IgA dominant post-infectious glomerulonephritis is a relatively recently described entity that typically presents with acute kidney injury, haematuria and proteinuria. Pathologically, the renal biopsy shows variable light microscopic findings ranging from mesangial hypercellularity to diffuse proliferative glomerulonephritis, but characteristic dominant or co-dominant IgA deposits by immunofluorescence, and subepithelial “hump”-shaped electron dense deposits. The majority of cases are associated with Staphylococcal infections. It is the aim of this review to discuss the salient clinical and pathologic features of IgA dominant post-infectious glomerulonephritis based on our own experience and review of the literature. Diagnostic criteria and pathophysiologic disease mechanisms are discussed.