IgA Nephropathy


Date: Wed, 05 Jun 1996 18:20:41 -0700 (MST)
From: Ron Hoggan

Well, I couldn't get a copy of the article she mentioned, but did find a 
number of articles that suggest that the gluten-free diet is a hotly 
debated therapy for IgA nephropathy. It seems that IgA anti-gliadin 
antibodies are elevated in patients with IgA nephropathy, but their 
antiendomysial & antireticulin antibodies counter the suggestion that 
this disease is associated with celiac disease. On the other hand, there 
are reports that indicate that the gluten-free diet "was able to reduce 
the levels of circulating IGA immune complexes." (2)

Apparently there is about a compromised life expectancy in this disease (3) 
so dietary intervention that reduces circulating antibodies, which are 
the agents of destruction, is seen as a viable therapy.

The other side of the argument is that because IgA nephropathy has been 
clearly demonstrated to have no visible relationship with celiac disease, 
and one study they cite was a trial of gluten-free diet on IgA nephropathy, 
which had little effect on the course of the nephropathy.

As we both know, the diet is quite a challenge, and I will peruse the 
article in question, to attempt to determine if compliance was monitored, 
and just how strict the diet was, and I'll report back to you. 

For now, it is clear that she was referring to the gluten-free diet, and 
this is a whole spectrum of possible gluten-intolerance that needs some 
investigation. 

1. Sategna-Guidetti, et. al. "Do IgA antigliadin and IgA antiendomysial
    antibodies show there is latent coeliac disease in primary IgA
    nephropathy?" Gut. 33(4): pages 476-478, Apr. 1992

2. Woodrow, et. al. "A case of IgA nephropathy with coeliac disease
    responding to a gluten-free diet" NEPHROLOGY, DIALYSIS, TRANSPLANTATION
    8(12): pages 1382-1383, 1993

3. Montinaro, et. al. "Primary IgA nephropathy: the relevance of  
    experimental models in the understanding of human disease" NEPHRON.
    62(4): pages 373-381, 1992

4. Dickey, et. al. "Is Measurement of Serum Antigliadin Antibodies in
    Patients with Suspected IgA Nephropathy Worthwhile?" NEPHRON 62(4):
    page 484, 1992

5. Coppo, et. al. "Dietary Antigens and Primary Immunoglobulin A
    Nephropathy" JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2(10
    Suppl): pages S173-180 Apr. 1992