[Case of rheumatoid arthritis with various histological lesions of the kidney].
We experienced a case of rheumatoid arthritis with nephrotic syndrome. A renal biopsy specimen from this patient showed various renal histological changes. The patient was a 50-year-old man who was diagnosed as having rheumatoid arthritis in 1987. We performed a renal biopsy because he had persistent proteinuria from March in 2002. The renal biopsy specimen showed amyloid AA and P protein deposition in the glomeruli. Moreover mild mesangial proliferation was recognized. IgA-deposition in the mesangial area, and granular-deposition of IgG along the glomerular capillary wall were also observed. In electron microscopy, electron dense deposits were recognized in the mesangial area and subepithelium of the glomerular basement membrane. From these findings, we diagnosed amyloid nephropathy, IgA nephritis and membranous nephropathy. Renal biopsy of patients with RA is useful not only for precise diagnosis, but also for selection of the appropriate treatment.
Division of Nephrology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan.
Masashi
M
Honma
Masao
M
Toyoda
Masaaki
M
Miyauchi
Naoyuki
N
Yamamoto
Moritsugu
M
Kimura
Mayumi
M
Maruyama
Makoto
M
Nishina
Mitsunori
M
Yagame
Masayuki
M
Endo
Hideto
H
Sakai
Daisuke
D
Suzuki
D017772:Amyloid Neuropathies / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology*; D018501:Antirheumatic Agents / Q000009:adverse effects; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D005922:Glomerulonephritis, IGA / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology*; D015433:Glomerulonephritis, Membranous / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology*; D006801:Humans; D007668:Kidney / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000209:etiology
D018501:Antirheumatic Agents