IgG4-Related Tubulointerstitial Nephritis Associated with Membranous Nephropathy in Two Patients: Remission after Administering a Combination of Steroid and Mizoribine
We report two cases of Japanese men who presented with proteinuria, eosinophilia, hypocomplementemia, and high serum immunoglobulin G4 (IgG4) concentration and were diagnosed with membranous nephropathy associated with IgG4-related tubulointerstitial nephritis on renal biopsy. The typical renal lesi...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2014-01-01
|
| Series: | Case Reports in Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2014/678538 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849473042593349632 |
|---|---|
| author | Kana N. Miyata Hiromi Kihira Manabu Haneda Yasuhide Nishio |
| author_facet | Kana N. Miyata Hiromi Kihira Manabu Haneda Yasuhide Nishio |
| author_sort | Kana N. Miyata |
| collection | DOAJ |
| description | We report two cases of Japanese men who presented with proteinuria, eosinophilia, hypocomplementemia, and high serum immunoglobulin G4 (IgG4) concentration and were diagnosed with membranous nephropathy associated with IgG4-related tubulointerstitial nephritis on renal biopsy. The typical renal lesions of IgG4-related disease are tubulointerstitial nephritis, which improves remarkably with steroid therapy, and occasional glomerular changes. In our two cases, renal biopsy revealed IgG4-positive immune complex deposits in glomeruli in a pattern of membranous nephropathy and concurrent tubulointerstitial nephritis with IgG4 plasma cells. In both cases, proteinuria persisted with initial prednisolone treatment and was resolved only after the addition of mizoribine. We report the first two cases in which the combination of prednisolone and mizoribine was effective for treating membranous nephropathy associated with IgG4-related tubulointerstitial nephritis. |
| format | Article |
| id | doaj-art-d995f25ef1904b6e9e6c273b51de6dc2 |
| institution | Kabale University |
| issn | 2090-6641 2090-665X |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Nephrology |
| spelling | doaj-art-d995f25ef1904b6e9e6c273b51de6dc22025-08-20T03:24:16ZengWileyCase Reports in Nephrology2090-66412090-665X2014-01-01201410.1155/2014/678538678538IgG4-Related Tubulointerstitial Nephritis Associated with Membranous Nephropathy in Two Patients: Remission after Administering a Combination of Steroid and MizoribineKana N. Miyata0Hiromi Kihira1Manabu Haneda2Yasuhide Nishio3Division of Nephrology and Hypertension, Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA 90502, USADivision of Nephrology, Department of Medicine, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu-shi, Tokyo 183-8524, JapanDivision of Nephrology, Department of Medicine, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu-shi, Tokyo 183-8524, JapanDivision of Nephrology, Department of Medicine, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu-shi, Tokyo 183-8524, JapanWe report two cases of Japanese men who presented with proteinuria, eosinophilia, hypocomplementemia, and high serum immunoglobulin G4 (IgG4) concentration and were diagnosed with membranous nephropathy associated with IgG4-related tubulointerstitial nephritis on renal biopsy. The typical renal lesions of IgG4-related disease are tubulointerstitial nephritis, which improves remarkably with steroid therapy, and occasional glomerular changes. In our two cases, renal biopsy revealed IgG4-positive immune complex deposits in glomeruli in a pattern of membranous nephropathy and concurrent tubulointerstitial nephritis with IgG4 plasma cells. In both cases, proteinuria persisted with initial prednisolone treatment and was resolved only after the addition of mizoribine. We report the first two cases in which the combination of prednisolone and mizoribine was effective for treating membranous nephropathy associated with IgG4-related tubulointerstitial nephritis.http://dx.doi.org/10.1155/2014/678538 |
| spellingShingle | Kana N. Miyata Hiromi Kihira Manabu Haneda Yasuhide Nishio IgG4-Related Tubulointerstitial Nephritis Associated with Membranous Nephropathy in Two Patients: Remission after Administering a Combination of Steroid and Mizoribine Case Reports in Nephrology |
| title | IgG4-Related Tubulointerstitial Nephritis Associated with Membranous Nephropathy in Two Patients: Remission after Administering a Combination of Steroid and Mizoribine |
| title_full | IgG4-Related Tubulointerstitial Nephritis Associated with Membranous Nephropathy in Two Patients: Remission after Administering a Combination of Steroid and Mizoribine |
| title_fullStr | IgG4-Related Tubulointerstitial Nephritis Associated with Membranous Nephropathy in Two Patients: Remission after Administering a Combination of Steroid and Mizoribine |
| title_full_unstemmed | IgG4-Related Tubulointerstitial Nephritis Associated with Membranous Nephropathy in Two Patients: Remission after Administering a Combination of Steroid and Mizoribine |
| title_short | IgG4-Related Tubulointerstitial Nephritis Associated with Membranous Nephropathy in Two Patients: Remission after Administering a Combination of Steroid and Mizoribine |
| title_sort | igg4 related tubulointerstitial nephritis associated with membranous nephropathy in two patients remission after administering a combination of steroid and mizoribine |
| url | http://dx.doi.org/10.1155/2014/678538 |
| work_keys_str_mv | AT kananmiyata igg4relatedtubulointerstitialnephritisassociatedwithmembranousnephropathyintwopatientsremissionafteradministeringacombinationofsteroidandmizoribine AT hiromikihira igg4relatedtubulointerstitialnephritisassociatedwithmembranousnephropathyintwopatientsremissionafteradministeringacombinationofsteroidandmizoribine AT manabuhaneda igg4relatedtubulointerstitialnephritisassociatedwithmembranousnephropathyintwopatientsremissionafteradministeringacombinationofsteroidandmizoribine AT yasuhidenishio igg4relatedtubulointerstitialnephritisassociatedwithmembranousnephropathyintwopatientsremissionafteradministeringacombinationofsteroidandmizoribine |