[Partial clinical remission of chronic IgA nephropathy with therapy of tuberculosis].
METHODS
A 36-year-old patient suffered from repeated exsudative pleural effusions and renal insufficiency (serum creatinine 1.9 mg/dl) combined with glomerular erythrocyturia, proteinuria and renal hypertension.


METHODS
The diagnosis of the underlying etiology of the pleural effusions was difficult in spite of a thorough diagnostic work-up. Pleural tuberculosis was finally detected by an interferon gamma release assay (IGRA). Kidney biopsy revealed mesangioproliferative glomerulonephritis, immunhistology showed mesangial IgA deposits. Renal insufficiency did not progress when blood pressure control was achieved.


METHODS
The pleural effusions resolved permanently when antituberculous treatment was begun. Eight weeks after initiation of therapy normalization of kidney function (eGFR > 75 ml/min), resolution of hematuria and reduction of proteinuria were observed.


CONCLUSIONS
This report of a partial remission of IgA nephropathy by treatment of pleural tuberculosis supports the hypothesis that there may be a causal relationship between mycobacterial infections and IgA nephropathy.
SRH Wald-Klinikum Gera GmbH, 2. Medizinische Klinik.
J
J
Ortmann
H
H
Schiffl
S M
SM
Lang
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001706:Biopsy; D004359:Drug Therapy, Combination; D005922:Glomerulonephritis, IGA / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D015432:Glomerulonephritis, Membranoproliferative / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D010996:Pleural Effusion / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014396:Tuberculosis, Pleural / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology
D000995:Antitubercular Agents