Macroscopic hematuria concomitant with acute pharyngitis is a characteristic feature of immunoglobulin A nephropathy (IgAN). Although the underlying mechanism of worsening hematuria has not been fully elucidated, activation of the innate immune system of nasopharynx-associated lymphoid tissue is thought to play an important role. The epipharynx is an immunologically activated site even under normal conditions, and enhanced activation of innate immunity is likely to occur in response to airborne infection. As latent but significant epipharyngitis presents in most IgAN patients, it is plausible that acute pharyngitis due to airway infection may contribute as a trigger of the epipharyngeal innate immune system, which is already upregulated in the chronically inflamed environment. The aim of this review was to discuss the mechanism of epipharynx-kidney axis involvement in glomerular vasculitis responsible for the worsening of hematuria in IgAN.

中文翻译：

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上咽肾轴触发免疫球蛋白A肾病中的肾小球血管炎。

伴有急性咽炎的肉眼血尿是免疫球蛋白A肾病（IgAN）的特征。尽管尚未完全阐明恶化的血尿的潜在机制，但据认为激活鼻咽相关淋巴组织的固有免疫系统起着重要作用。即使在正常条件下，上咽也是一个免疫激活的位点，响应于空气传播的感染，固有免疫的激活可能会增强。由于在大多数IgAN患者中都存在潜伏但重要的咽炎，因此，由气道感染引起的急性咽炎可能是引起上咽先天免疫系统的诱因，而后者在慢性发炎的环境中已被上调。