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  Vol. 135 No. 1, January 2009 TABLE OF CONTENTS
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The Role of Tonsillectomy in Pediatric IgA Nephropathy

Adam J. Mariotti, MD; Rekha Agrawal, MD; Andrew J. Hotaling, MD

Arch Otolaryngol Head Neck Surg. 2009;135(1):85-87.

Objectives  To review pediatric cases of IgA nephropathy (IgAN) in 6 patients who underwent tonsillectomy and had marked improvement of their renal symptoms and to review the appropriate indications for tonsillectomy for this disease.

Design  Retrospective case series.

Setting  Academic medical center.

Patients  Six children (age range, 8-15 years) with renal biopsy-proved IgAN who were referred by a pediatric nephrologist for recurrent tonsillitis.

Intervention  Tonsillectomy.

Main Outcome Measures  Resolution of clinical features of IgAN, including proteinuria, gross and microscopic hematuria, and stabilization of renal function.

Results  The 6 patients in this series had marked clinical and laboratory improvement of their nephropathy.

Conclusions  In a select group of pediatric cases of IgAN with mild to moderate disease and recurrent tonsillitis, tonsillectomy can be a useful adjuvant treatment to improve urinary symptoms and renal function. IgA nephropathy is a common indication for tonsillectomy in Japan but is seen less often in the United States. Otolaryngologists should be aware of this indication for tonsillectomy.


Author Affiliations: Departments of Otolaryngology–Head and Neck Surgery (Drs Mariotti and Hotaling) and Pediatrics (Drs Agrawal and Hotaling), Loyola University Medical Center, Maywood, Illinois.



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