Renal granuloma and immunoglobulin M-complex glomerulonephritis: a case of common variable immunodeficiency?
Common variable immunodeficiency (CVID) is characterized by reduced serum immunoglobulin levels and recurrent bacterial infections. Granulomatous infiltrations are occasionally found in the lymphoid or solid organs of affected patients, but renal involvement is rare. We present a case of possible CVID with interstitial noncaseating granuloma and immunoglobulin (IgM)-complex glomerulonephritis with a membranoproliferative pattern and with a favorable response to corticosteroids, intravenously administered immunoglobulins (IVIGs) and rituximab. CVID must be included in the differential diagnosis of renal granuloma and should be differentiated from sarcoidosis to ensure appropriate therapy.
Benoit
Geneviève
G
Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, 3175 Chemin de la Côte Sainte-Catherine, Montreal, Quebec, Canada.
Lapeyraque
Anne-Laure
AL
Sartelet
Hervé
H
Saint-Cyr
Claire
C
Le Deist
Françoise
F
Haddad
Elie
E
D000293:Adolescent; D001706:Biopsy; D017074:Common Variable Immunodeficiency / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D015432:Glomerulonephritis, Membranoproliferative / Q000209:etiology / Q000473:pathology*; D006099:Granuloma / Q000209:etiology / Q000473:pathology*; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis*; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007668:Kidney / Q000473:pathology; D007674:Kidney Diseases / Q000209:etiology / Q000473:pathology*
D007075:Immunoglobulin M; D016756:Immunoglobulins, Intravenous