Idiopathic membranous nephropathy in a patient diagnosed with IgG4-related disease
Autor: | Ma, XiaoYing, Xu, HaiPing, Sun, Jing Yi, Gedara, Yuresha Surangani Siyabalagaba, Sun, FuYun |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
membranous nephropathy associated with immunoglobulin G4-related disease
Anti-Inflammatory Agents idiopathic membranous nephropathy Retroperitoneal Fibrosis Middle Aged Glomerulonephritis Membranous Methylprednisolone immunoglobulin G4-related disease parasitic diseases case report Humans Nephritis Interstitial Prednisone Female Clinical Case Report monoclonal immunoglobulinemia syndrome Research Article |
Zdroj: | Medicine |
ISSN: | 1536-5964 0025-7974 |
Popis: | Rationale: Immunoglobulin (Ig) G4-related disease (IgG4-RD) is a newly recognized, systemic disease. Membranous nephropathy is the most common glomerular lesion in IgG4- related kidney disease. However, the lack of relationship with IgG4-related kidney disease and monoclonal gammopathy of undetermined significance (MGUS) warrants investigation of the potential mechanisms. Patient concerns: A 62-year-old patient was diagnosed with IgG4-RD, tubulointerstitial nephritis, retroperitoneal fibrosis. After 2 years, she was presented with proteinuria, hypoproteinemia, facial, and bilateral lower limb edema. Furthermore, this patient exhibited deposits of IgG k of monoclonal hyperplasia, and bone marrow plasma cell count was 2.5%. Diagnosis: The patient was diagnosed with nephrotic syndrome, acute kidney injury, and MGUS. The pathological diagnosis was IgG4-related tubulointerstitial nephritis, IgG4-related membranous nephropathy. Interventions: The patient was treated with intravenous methylprednisolone (40 mg daily), which was changed to oral prednisone 50 mg/d after 2 months. Outcomes: After 1 month, the patient exhibited a rapid response only with corticosteroid, and experienced partial remission of serum albumin and proteinuria. Lessons: This case may suggest a possible relationship between IgG4-RD and MGUS, provide some guidance for investigating the mechanism between them. |
Databáze: | OpenAIRE |
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