IgA nephropathy in a patient with polycythemia vera. Clinical manifestation of chronic renal failure and heavy proteinuria.
IgA nephropathy (IgAN) is one of the most frequent forms of glomerulonephritis (GN). However, its association with polycythemia vera (PV) has rarely been described. We report a case of IgAN combined with PV. The patient was a 46-year-old male with chronic renal failure, heavy proteinuria and erythrocytosis. He also presented hypertension and hematuria as well as splenomegaly, high arterial oxygen saturation and elevated leukocyte alkaline phosphatase activity. Possible causes of secondary erythrocytosis were ruled out. The renal biopsy revealed mesangial proliferative GN with predominant IgA deposition in mesangium. He was diagnosed as having IgAN and PV concomitantly. After administration of hydroxyurea, enalapril and felodipine, blood cell count and blood pressure normalized, while azotemia persisted. There was also a partial remission of the heavy proteinuria. We describe a case of IgAN associated with PV, and possible pathophysiologic relationships between two diseases are discussed with review of the literature.
Chung
Jaegul
J
Department of Diagnostic Pathology, Asan KangNung Hospital, KangNung City, South Korea. gzz@ghil.com
Park
Pae Gun
PG
Song
Kyung-il
KI
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D004656:Enalapril / Q000627:therapeutic use; D015736:Felodipine / Q000627:therapeutic use; D005922:Glomerulonephritis, IGA / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D008875:Middle Aged; D011087:Polycythemia Vera / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011507:Proteinuria / Q000209:etiology
D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D004656:Enalapril; D015736:Felodipine; D006918:Hydroxyurea