Abstract:

Objective To summarize and analyze the clinical and pathological characteristics and short-term outcomes of eight children diagnosed with concomitant IgA nephropathy (IgAN) and membranous nephropathy (MN). Methods This retrospective case series included eight pediatric patients with biopsy-proven IgAN+MN between January 2014 and December 2024. Clinical manifestations, laboratory findings, and renal histopathology were reviewed and summarized, and the results were compared with those reported in the literature. Results The cohort comprised eight children (4 boys and 4 girls), with a median age at onset of 7 years. The main clinical presentations were gross hematuria and/or proteinuria. Nephrotic syndrome occurred in 50% of patients, and hematuria was observed in 87.5%. Renal pathology predominantly demonstrated mesangial proliferative glomerulonephritis accompanied by early- to intermediate-stage membranous lesions. Immunofluorescence showed IgA deposition in the mesangium and IgG deposition along the glomerular basement membrane. All patients were treated with glucocorticoids in combination with immunosuppressive agents. Complete remission was achieved in all cases (100%), with a median time to remission of 2 months (range, 1-5 months). Conclusion Pediatric IgAN+MN shows overlapping clinical phenotypes of IgAN and MN. Treatment with glucocorticoids plus immunosuppressants appears to be highly effective, and short-term prognosis is favorable. Early diagnosis and active intervention may improve outcomes; however, long-term follow-up is needed to monitor relapse and chronic progression.

Key words: IgA nephropathy, membranous nephropathy, clinicopathological features, prognosis, child