Secondary IgA nephropathy presenting as nephrotic syndrome with glomerular crescentic changes and acute renal failure in a patient with autoimmune hepatitis.
Patients with end-stage liver disease are prone to hemodynamic and immunologic renal injury, the latter at times manifesting as glomerulonephritis. Elevated serum immunoglobulin A (IgA) levels and mesangial IgG-IgA deposits are common in these patients, but are often clinically silent. We report a patient with autoimmune hepatitis and secondary IgA nephropathy (IgAN) who presented with nephrotic syndrome, acute renal failure (ARF), with 30% of the renal glomeruli having undergone crescentic change, and with IgA2 deposits in the glomerular mesangium. This article discusses secondary IgAN pathogenesis and its therapeutic management.
Singri
Naveen
N
Division of Nephrology and Hypertension, Feimberg School of Medicine, Northwestern University, Chicago 60611, USA.
Gleason
Briana
B
Flamm
Steve L
SL
Kanwar
Yashpal S
YS
Ghossein
Cybele
C
D058186:Acute Kidney Injury / Q000209:etiology* / Q000473:pathology; D000328:Adult; D005260:Female; D005922:Glomerulonephritis, IGA / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D019693:Hepatitis, Autoimmune / Q000150:complications* / Q000628:therapy; D006801:Humans; D007678:Kidney Glomerulus / Q000473:pathology*; D009404:Nephrotic Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology