Tonight I was in the hospital seeing a patient …and a nehprologist colleague stopped me in the hall and we blabbed for a few minutes.
I asked him about a patient of mine who has IgA nephropathy. After 10 years without any trouble, she developed mastitis (btw – this link is a great review of mastitis and its causes and management) and then developed gross hematuria.
His first thought was that this was odd because he usually sees "IgA nephropathy worsening with infections of organs that involve .. IgA .. like the lungs." Then I reminded him that breasts sure do involve IgA.
Interestingly, there are only two case reports of mastitis causing exacerbations of IgA nephropathy in the literature. Perhaps we need a third.
So then he teaches me about suggesting fish oil to my patients with IgA nephropathy.
uh .. since the prevalence is about 1:4500, it's not likely I'll have more than 1 patient with IgA nephropathy for a few years. Ther are about 3000 patients in our practice — of which about 1,000 call me their primary care physician.
Nonetheless, it's something that I'm interested in. If fish oil will really alter the progression of this disease … I'm all for it. Here's a great review (pdf) of the state of affairs with fish oil and IgA nephropathy.