[Case of Henoch-Schönlein purpura nephritis associated with IgA monoclonal gammopathy of undetermined significance].
We report the case of a 72-year-old man with nephritic syndrome and rapidly progressive renal failure due to Henoch-Schönlein purpura nephritis (HSPN). He was successfully treated with methylprednisolone pulse therapy, followed by oral prednisolone at the dose of 30 mg per day. He was also diagnosed by immunoelectrophoresis as IgA-lambda monoclonal gammopathy of undetermined significance (IgA-MGUS). Renal biopsy revealed the diffuse crescentic glomerulonephritis associated with mesangial deposition of IgA and C3. Since an immunofluorescence examination failed to show the deposition of lambda, the significance of IgA paraproteinemia on the HSPN was obscure in the present case. However, we must bear in mind the latent presence of IgA-MGUS in cases of HSPN.
Meguro
Daishi
D
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
Akimoto
Tetsu
T
Nakazawa
Eiko
E
Onishi
Akira
A
Inoue
Makoto
M
Saito
Osamu
O
Muto
Shigeaki
S
Kusano
Eiji
E
D000368:Aged; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications* / Q000188:drug therapy; D007070:Immunoglobulin A; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D009393:Nephritis / Q000150:complications* / Q000188:drug therapy; D009404:Nephrotic Syndrome / Q000188:drug therapy / Q000209:etiology*; D010265:Paraproteinemias / Q000150:complications* / Q000175:diagnosis; D011239:Prednisolone / Q000008:administration & dosage; D020551:Pulse Therapy, Drug; D051437:Renal Insufficiency / Q000188:drug therapy / Q000209:etiology
D007070:Immunoglobulin A; D011239:Prednisolone; D008775:Methylprednisolone