Association of acute tubular necrosis with gross hematuria in cirrhosis-related immunoglobulin A nephropathy

Kidney Research and Clinical Practice

Sung Chul Hong¹  Jong Ho Lee¹  Mi Jin Hong¹  Won Hyeok Choi¹  Jung Hee Park¹  Eugene Park¹  Jong Oh Song¹  Cho I Lee¹  Jung Hwan Park¹  Young Il Jo¹  Jang Soo Han¹  So Dug Lim² 

[1] Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea;Department of Pathology, Konkuk University School of Medicine, Seoul, Korea;

关键词: Cirrhosis;    Hematuria;    Lamivudine;    Renal failure;   

DOI  :  10.1016/j.krcp.2012.12.003

来源: DOAJ

【 摘 要 】

Immunoglobulin A (IgA) nephropathy associated with cirrhosis is the most common form of secondary IgA nephropathy (IgAN). Cirrhosis-related IgAN is usually clinically silent with a rare occurrence of gross hematuria, unlike in cases of idiopathic IgAN. Especially, acute tubular necrosis (ATN) associated with gross hematuria is very rare in cirrhosis-related IgAN, although acute renal failure is a frequently reported complication in advanced cirrhosis. Herein, we report an unusual case of ATN requiring renal replacement therapy, associated with gross hematuria in a patient with nonalcoholic, hepatitis B virus-associated cirrhosis. Results of a histopathological analysis revealed obstruction of the lumen of renal tubules by red blood cell casts, a marked tubular necrosis, and IgA deposition in the mesangium. The patient's renal function and gross hematuria were clearly improved after lamivudine treatment.

【 授权许可】

Unknown