Concurrent IgG4-related tubulointerstitial nephritis and IgG4 myeloperoxidase-anti-neutrophil cytoplasmic antibody positive crescentic glomerulonephritis: A case report

Medicine
Tao SuMing-Hui Zhao

Abstract

IgG4-related disease (IgG4-RD) is a newly recognized systemic disease. The typical pathological finding in the kidney is abundant IgG4-positive plasma cell infiltration with characteristic storiform fibrosis in the interstitium. Antibodies of the IgG4 subclass have been linked to certain autoimmune diseases including antiproteinase 3 (PR3) anti-neutrophil cytoplasmic antibody (ANCA) of the IgG4 subclass. Here, we report a rare case of kidney injury with concurrent typical IgG4-related tubulointerstitial nephritis and IgG4 subclass of myeloperoxidase (MPO) ANCA-positive necrotizing crescentic glomerulonephritis. A 42-year-old Chinese man presented with repeated epigastric pain, sausage-shaped pancreas observed morphologically in computed tomography, effectiveness of prednisone therapy and was diagnosed with autoimmune pancreatitis. He subsequently developed acute kidney injury. The patient had an elevated serum IgG4, eosinophilia, and positive MPO-ANCA of IgG4-dominant subclass. Renal biopsy revealed necrotizing crescentic nephritis and typical IgG4-related tubulointerstitial nephritis. The patient was treated with a combination of corticosteroids and cyclophosphamide, and a course of rituximab was later added to deplete periphe...Continue Reading

References

Nov 1, 1993·Allergy·R C AalberseS O Stapel
Aug 21, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Susan L HoganRonald J Falk
Jun 28, 2011·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Donald C Houghton, Megan L Troxell
Jul 2, 2011·Journal of the American Society of Nephrology : JASN·Yassaman RaissianLynn D Cornell
Feb 10, 2012·The New England Journal of Medicine·John H StoneVikram Deshpande
May 19, 2012·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Vikram DeshpandeJohn H Stone
Oct 10, 2012·Arthritis and Rheumatism·J C JennetteR A Watts
Jun 25, 2013·Medicine·Zachary S WallaceJohn H Stone
Jun 26, 2013·Current Rheumatology Reports·Rodolfo Perez AlaminoLuis R Espinoza
Mar 13, 2014·Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine·Kengo TanigawaHiromasa Inoue
Feb 11, 2015·Annals of the Rheumatic Diseases·Mollie N CarruthersJohn H Stone
Apr 12, 2015·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Stoyan PopkirovSabine Skodda
Dec 17, 2015·Journal of Pathology and Translational Medicine·Hyeon Joo JeongBeom Jin Lim
Dec 27, 2015·The American Journal of Medicine·Krystallenia I AlexandrakiGregory A Kaltsas
May 4, 2016·Clinical Rheumatology·David Herrera van OostdamCarlos Abud Mendoza

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Citations

Oct 2, 2019·International Journal of Rheumatic Diseases·Abdulsamet ErdenOmer Karadag
Sep 6, 2019·Clinical and Experimental Nephrology·Naoko MasuzawaEiichi Konishi
Oct 23, 2020·Modern Rheumatology Case Reports·Ryuichiro KandaYoshiya Tanaka
Feb 17, 2021·Clinical Rheumatology·Arzu Meltem DemirUmut Selda Bayrakci
Apr 20, 2021·Frontiers in Medicine·Riccardo CapecchiPaola Migliorini

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Methods Mentioned

BETA
biopsy

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