The Role of Tonsillectomy in Pediatric IgA Nephropathy

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.