Clinical course of chronic tonsillitis in patients with IgA nephropathy

S.A. Karpischenko^1,2, O.M. Kolesnikova¹, Yu.V. Legkova¹

¹Pavlov First Saint Petersburg State Medical University, Saint Petersburg

²Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech, Saint Petersburg

Chronic tonsillitis (CT) is one of the most common pathologies in otorhinolaryngological practice, characterized by the presence of focal chronic infection in the palatine tonsils. According to the WHO, there are about 100 diseases that can be associated with CT, one of which is IgA nephropathy.

Aim: to evaluate the CT clinical course in patients with IgA nephropathy.

Patients and Methods: 111 patients with CT (46 women and 65 men; average age — 34.5±9.3 years) underwent the study. Complaints, medical history data, and pharyngoscopy images were analyzed according to the developed rating scales from 0 to 3 or from 0 to 1.

Results: the majority of patients (44%) rarely noted a sore throat and did not observe the discharge of tonsilloliths (66% of patients); foul smell and bad breath disturbed only 0.5% of patients. Body temperature rarely rose to subfebrile numbers (42%) or did not rise at all (41%), but patients commonly complained of fatigue (almost 80%). In medical history, this group of patients rarely noted common angina (less than 1%) or sore throat (6.6%), whereas, regional lymph nodes growth was observed in 42% of cases, pain or joint ache — in 47%. Topical complications of angina were detected in only 1 patient in the form of paratonsi llar abscess. Most patients were not treated for CT (80%) and in 62% of cases, patients did not notice changes in urine during the period of sore throat. During pharyngoscopy images evaluation, hypertrophy of the palatine tonsils rarely exceeded the first degree, tonsilloliths discharge was also minimal, most patients had hyperemia of the faucial pillars and cicatricial changes between the tonsillar capsule and surrounding tissues.

Conclusion: CT in IgA-nephropathy is characterized by a subclinical picture and scant history data, which makes it difficult to provide treatment tactics. Timely and early diagnosis of CT, especially form free from angina, leads to the prevention of complications from various organs and systems.

Keywords: chronic tonsillitis, IgA nephropathy, tonsillogenic reactions, form free from angina, tonsillectomy.

For citation: Karpischenko S.A., Kolesnikova O.M., Legkova Yu.V. Clinical course of chronic tonsillitis in patients with IgA nephropathy. RMJ. 2020;5:13–16.