IgA nephropathy featuring massive wire loop-like deposits in two patients with alcoholic cirrhosis

BMC Nephrology

Case Report

Takeshi Fujii¹  Kenichi Ohashi²  Masayuki Yamanouchi³  Junichi Hoshino³  Tatsuya Suwabe³  Akinari Sekine³  Noriko Hayami³  Ryo Hazue³  Keiichi Sumida³  Daisuke Takada³  Naoki Sawa³  Yoshifumi Ubara⁴  Kenmei Takaichi⁴ 

[1] Department of Pathology, Toranomon Hospital, Tokyo, Japan;Department of Pathology, Toranomon Hospital, Tokyo, Japan;Department of Pathology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan;Nephrology Center, Toranomon Hospital Kajigaya, 1-3-1, Takatsu, 213-8587, Kawasaki, Kanagawa, Japan;Nephrology Center, Toranomon Hospital Kajigaya, 1-3-1, Takatsu, 213-8587, Kawasaki, Kanagawa, Japan;The Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan;

关键词: Wire loop-like subendothelial deposit;    Alcoholic cirrhosis;    IgA nephropathy;   

DOI  :  10.1186/s12882-017-0769-1

 received in 2016-08-28, accepted in 2017-11-20,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundVarious renal manifestations are known to develop in patients with liver disease, including chronic hepatitis and cirrhosis.Case presentationWe evaluated renal disease in two 47-year-old Japanese men with liver cirrhosis and chronic alcoholism for 34 years and 27 years, respectively. Renal biopsy demonstrated massive wire loop-like deposits in the subendothelial space of the glomerular basement membrane and in the mesangium. However, immunofluorescence was only positive for IgA and C3, and electron microscopy did not reveal any organized structures in the electron-dense deposits. IgA nephropathy was diagnosed, although the features were different from primary IgA nephropathy. Both patients had portosystemic shunts associated with liver cirrhosis. Their renal deposits and proteinuria resolved completely after 1 year of steroid therapy.ConclusionAlcohol abuse may have contributed to development of secondary IgA nephropathy in these two patients, probably via their portosystemic shunts.

【 授权许可】

CC BY   
© The Author(s). 2017