title: Acute renal failure in IgA nephropathy: aggravation by gross hematuria due to anticoagulant treatment.
abstract: IgA nephropathy is one of the most common forms of glomerulonephritis. Macroscopic or microscopic hematuria with mild proteinuria are the main symptoms. Without complicating factors, IgA nephropathy has a favourable long-term prognosis. We report a case of reversible acute renal failure (ARF) as a complication of mild IgA nephropathy while oral anticoagulants were administered. Diagnosis was based on a renal biopsy showing marked granular mesangial IgA-deposition. In addition, numerous tubules were extended and completely obstructed by red blood cell casts. After hemodialysis treatment and parallel anti-inflammatory steroids and after stopping anticoagulation, renal function gradually improved up to complete remission. This report indicates that anticoagulatory treatment may have negative effects on the long-term prognosis of IgA nephropathy with respect to development of ARF or tubulo-interstitial inflammation.
authors.affiliation: Gerhard-Domagk Institute of Pathology, University of Münster, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: August
authors.forename: Andreas
authors.initials: A
authors.lastname: Atzeni
authors.forename: Ludger
authors.initials: L
authors.lastname: Köster
authors.forename: Stefan
authors.initials: S
authors.lastname: Heidenreich
authors.forename: Detlef
authors.initials: D
authors.lastname: Lang
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000628:therapy; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D001707:Biopsy, Needle; D005260:Female; D005500:Follow-Up Studies; D005922:Glomerulonephritis, IGA / Q000150:complications / Q000473:pathology*; D006417:Hematuria / Q000139:chemically induced* / Q000503:physiopathology; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000150:complications / Q000188:drug therapy*
chemical_list: D000925:Anticoagulants