Pathologies of the kidneys are quite common. These include infections such as pyelo- and glomerulonephritis. In addition to them, there are other pathologies of the urinary system. One of them is Berger's disease. This pathology also refers to common anomalies. It is diagnosed in approximately 20% of cases of kidney disease in men. This violation applies not only to problems of nephrology, as it has an immune mechanism of development. This pathology can be suspected by the main symptom - macrohematuria.
Berger's disease - what is it?
This pathology is a form of chronic glomerulonephritis. Compared with the hypertensive and nephrotic course, Berger’s disease has a more favorable prognosis. Despite the fact that she is diagnosed at an early age (15-30 years), she rarely goes into severe renal failure. The main manifestations of the disease are macrohematuria and discomfort in the lumbar region. This pathology can also occur in childhood. In the male population, it occurs 4 times more often than among women. As with all pathologies, the diagnosis is made according to the international classification of diseases (ICD). Berger's nephropathy has the code N02, which means "stable and recurrent hematuria."
Causes of the disease
The main cause of the disease is the infectious process. Most often, kidney pathology develops after previous viral and bacterial infections. Fungal diseases can also be the cause. Usually, symptoms appear several days after the infection subsides in the upper respiratory tract (ARVI, tonsillitis, pharyngitis). The immediate cause of the disease is the accumulation of immune complexes in the walls of the renal vessels. In some cases, a pathology is associated with a burdened hereditary history (familial IgA nephropathy). In addition, the disease is associated with a genetic predisposition. The following provocative factors are distinguished:
- Hypothermia.
- Decreased immunity.
- Chronic viral and bacterial processes in the upper respiratory tract.
The mechanism of development of Berger disease
The pathogenesis of the disease is associated with the deposition of immune complexes in the walls of blood vessels. Normally, the glomerular apparatus of the kidneys is responsible for filtering the blood. It consists of many nephrotic vessels. After the infection, elements of the inflammatory process - immune complexes - remain in the body and settle in the glomerular apparatus. As a result of this, glomerulonephritis develops. The renal vessels cannot function normally due to immune complexes, and blood filtration is impaired. In addition, the inflammatory process causes fluid accumulation (parenchyma edema) and reduces the permeability of the basement membrane. As a result of this, macro- and microhematuria develop. The causes of these processes are damage to the renal glomeruli and the penetration of fluid (blood) through the basement membrane.
What are the symptoms of Berger disease?
The clinical picture of Berger's disease resembles acute glomerulonephritis. Nevertheless, it is important to distinguish between these diseases among themselves. The cause of glomerulonephritis is most often a staph infection. The methods of treating these diseases also differ. The main symptoms of Ig A nephropathy are:
- Hematuria Most often, it is this symptom that makes patients seek medical help. Macrohematuria means the appearance of blood during urination. Often this is accompanied by unpleasant sensations.
- Microhematuria is a symptom that remains invisible to humans and is detected only in special tests.
- Pain in the lumbar region. Most often they are dull aching in nature. Unlike other inflammatory processes in the kidneys (pyelonephritis), discomfort is observed on both sides.
- The presence of a previous upper respiratory tract infection.
- Fever.
- General weakness.
- Proteinuria - the appearance of protein in the urine. It is noted in rare cases, with an atypical course of the disease.
Diagnosis of Ig A-Nephropathy
The main diagnostic criterion for Berger disease is a chronic course. Usually, the symptoms disturb the patient 2-3 times a year, after infections. It is also important to note that the disease is benign. Despite the occasional hematuria, the condition of the kidneys remains normal. Unlike other inflammatory processes (pyelo-, glomerulonephritis), with Berger’s disease, chronic renal failure rarely develops.
Laboratory diagnostics include OAC, OAM, and special urine samples (Nechiporenko, Zimnitsky). They are necessary for the detection of red blood cells and white blood cells. Depending on this, micro- and macrohematuria are distinguished. In a general urinalysis, protein may be present. To check if there is a violation of kidney function, the patient must donate blood from a vein to biochemistry. In this analysis, it is important to know the level of creatinine that remains normal in Berger disease. To make a final diagnosis, a study is performed for the presence of Ig A in the blood. In rare cases, a kidney biopsy is performed, in which immune complexes are found in the vascular apparatus. Ultrasound is also performed for differential diagnosis.
Immunological inflammation of the kidney: treatment
Despite the benign course of the disease, therapy is necessary during relapses. It is needed not only to ease the symptoms of pathology, but also to prevent complications and preserve kidney function. Treatment begins with the reorganization of the foci of infection. Most often, antibiotics (Amoxicillin, Cefazolin preparations) and antiviral drugs (Viferon, Genferon medicines) are prescribed for this. In addition, NSAIDs are needed to relieve inflammation in the glomerular apparatus of the kidneys. The most commonly used drugs are Kanefron, Ibuprofen. For kidney diseases, herbal medicines are effective. Special decoctions and infusions (knotweed, birch cones, bearberry) are also prescribed.
If the disease is difficult to treat, frequent relapses or complications are noted, then hormone therapy is performed. Usually prescribe the drug "Prednisolone", as well as cytotoxic drugs. In some cases, antiplatelet therapy, means to improve blood flow (medication "Curantil") are necessary.
Berger Disease Prevention
It should be remembered that Berger disease refers to chronic pathologies. Therefore, in order to avoid exacerbations, it is necessary to carry out preventive measures. It is important to sanitize the foci of infection in time (tonsillitis, sinusitis), not to be exposed to hypothermia. Also, patients should periodically conduct phytotherapy courses, support the immune system.