Nephrotic IgA nephropathy associated with disseminated tuberculosis.
A 35-year-old woman who had been suffering from ascites more than 3 months after the delivery of her first baby, developed generalized edema, pyrexia, pleural effusion, and right lower abdominal pain. The laboratory data revealed 5.6 g of 24-hour urinary protein, increased ESR and CRP, a positive skin test for tuberculosis, and a positive culture fortuberculous bacilli from pleural effusion. A renal biopsy showed mild proliferative glomerulonephritis, IgA and C3 depositions along the capillary loop, in the mesangium and also in the focal tubular basement membrane, and scattered membranolysis of the glomerular basement membrane in addition to paramesangial and intramembranous electron-dense deposits. A positive culture of tuberculous bacilli led anti-tuberculous drugs resulted in the complete disappearance of proteinuria, inflammation, and various organ manifestations. As far as we know, the association of tuberculosis with glomerulonephritis is an uncommon occurrence. In addition to describing this case, we also discussed the role of tuberculosis in the pathogenesis of glomerulonephritis, and reviewed the pertinent literature.
Matsuzawa
N
N
First Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan.
Nakabayashi
K
K
Nagasawa
T
T
Nakamoto
Y
Y
D000328:Adult; D002097:C-Reactive Protein; D005260:Female; D005922:Glomerulonephritis, IGA / Q000382:microbiology*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D010996:Pleural Effusion / Q000382:microbiology; D011507:Proteinuria / Q000209:etiology; D014374:Tuberculin Test; D014391:Tuberculosis, Miliary
D007070:Immunoglobulin A; D002097:C-Reactive Protein