A case of rapidly progressive IgA nephropathy in a patient with exacerbation of Crohn’s disease

BMC Nephrology

Sun-Hee Park¹  Yong-Lim Kim¹  Chan-Duck Kim¹  Jang-Hee Cho¹  Yong-Jin Kim²  Min Kyu Jung³  Hee-Yeon Jung¹  Chung Hoon Yu¹  Ji-Young Choi¹ 

[1] Division of Nephrology, Department of Internal Medicine, Kyungpook National University School of Medicine and Clinical Research Center for End Stage Renal Disease in Korea, 130 Dongduk-ro, Jung-gu, Daegu, South Korea;Department of Pathology, Yeungnam University School of Medicine, Daegu, South Korea;Division of Gastroenterology, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea

关键词: Crohn’s disease;    Rapidly progressive IgA nephropathy;   

Others  :  1083126
DOI  :  10.1186/1471-2369-13-84

 received in 2012-05-22, accepted in 2012-07-28,  发布年份 2012

【 摘 要 】

Background

IgA nephropathy has been reported as a renal involvement in Crohn’s disease. Crescentic IgA nephropathy, which accounts for fewer than 5% of cases of IgA nephropathy, has a poorer prognosis than other forms of crescentic glomerulonephritis. We recently experienced a case of rapidly progressive IgA nephropathy concurrent with exacerbation of Crohn’s disease.

Case presentation

An 18-year-old male diagnosed with Crohn’s disease underwent a hemicolectomy 2 years prior previously. He had maintained a state of Crohn’s disease remission with 5-aminosalicylic acid treatment. Four months prior to referral to the nephrology clinic, he experienced non-bloody diarrhea. He simultaneously developed proteinuria and microscopic hematuria with deterioration of renal function. Based on renal biopsy findings, the patient was diagnosed with crescentic IgA nephropathy. Immunostaining for interleukin-17 in renal tissue and previous exacerbated colonic ulcers was positive. Steroid pulse therapy was administered, followed by high-dose glucocorticoid and oral cyclophosphamide therapy. The patient’s renal function recovered and his gastrointestinal symptoms were alleviated.

Conclusions

We report a case of crescentic IgA nephropathy presenting with exacerbation of Crohn’s disease, and present a review of the literature focusing on the pathophysiologic relationship between these two conditions.

【 授权许可】

   
2012 Choi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 1.

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