IgA腎症に対する口蓋扁桃摘出術の有効性と安全性の検討

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  • Efficacy and Safety of a Tonsillectomy for the Treatment of IgA Nephropathy
  • 臨床 IgA腎症に対する口蓋扁桃摘出術の有効性と安全性の検討
  • リンショウ IgAジンショウ ニ タイスル コウガイ ヘントウ テキシュツジュツ ノ ユウコウセイ ト アンゼンセイ ノ ケントウ

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<p>We performed a retrospective statistical analysis to evaluate the safety, efficacy and effectiveness of a tonsillectomy for the treatment of immunoglobulin A nephropathy (IgAN).</p><p>Forty-four patients were included in the study. The safety and efficacy of the surgical techniques were confirmed by the frequency of postoperative bleeding and the mean operative time, which were equal to those observed after tonsillectomies in patients with diseases other than IgAN. The median duration of hospitalization was 7 days. For comparison, patients were divided into three groups: a non-operative group, a tonsillectomy alone group, and a group with a tonsillectomy followed by the pulse administration of a glucocorticoid (TSP). Statistical analyses were performed to determine changes in the following indices between the pretreatment levels and the levels at one year after the completion of treatment: (1) daily urine protein level, (2) urine red blood cell count, (3) clinical remission rate of urine, and (4) urine clinical remission rates of histopathological prognostic categories at the point of diagnosis. The results showed that the latter two groups that had undergone a tonsillectomy both had significantly better improvements, compared with the non-operative group. However, no statistical difference in the clinical remission rates was seen between the latter two groups, although the rate for the tonsillectomy alone group was higher. The remission rates for the three prognostic categories were 53%–78%, and no significant difference were observed among the categories. In conclusion, surgical therapy for IgAN tonsillectomy was performed safely and with no increase in the hospitalization time. A tonsillectomy alone and TSP were both effective for the treatment of IgAN, although a significant difference between the two treatments was not observed. The accumulation of a larger number of cases treated with a tonsillectomy alone is needed to determine the indications for a tonsillectomy in patients with IgAN.</p>

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