[Glomerular nephropathy with IgA mesangium deposits and Crohn disease].
BACKGROUND
Renal disease is an unfrequent extraintestinal manifestation of chronic inflammatory bowel disease.


METHODS
A 12-year-old girl suffered from recurrent abdominal pain, diarrhea and growth impairment due to Crohn's disease of ileocaecal region. After six months of nutritional rehabilitation, an ileo-caecal resection was performed because of intestinal stenosis. The surgical procedure was followed by parietal abcess and cutaneous fistula. One year later, a purulent secretion came out of the fistula associated with fever, hematuria and acute renal failure. Renal biopsy confirmed IgA nephropathy. The course was favorable under parenteral nutrition and after surgical closure of the sigmoido-cutaneous fistula. The microscopic hematuria only persisted but the nephropathy did not relapse even during a further digestive exacerbation.


CONCLUSIONS
IgA nephropathy has been reported in association with chronic inflammatory bowel disease. Its mechanism remains unclear: increased mucosal IgA production in inflammatory bowel, increased serum IgA and/or immune complex deposition in the renal mesangium appear the most relevant hypotheses.
Dabadie
A
A
Pédiatrie génétique médicale, CHU Pontchaillou, Rennes, France.
Gié
S
S
Taque
S
S
Babut
J M
JM
Roussey
M
M
D058186:Acute Kidney Injury / Q000209:etiology; D002648:Child; D003424:Crohn Disease / Q000150:complications* / Q000601:surgery; D005260:Female; D005920:Glomerular Mesangium / Q000473:pathology; D005922:Glomerulonephritis, IGA / Q000150:complications* / Q000175:diagnosis / Q000209:etiology; D006801:Humans
Néphropathie glomérulaire à dépôts mésangiaux d'IgA et maladie de Crohn.