IgG4-related chronic tubulointerstitial nephritis without autoimmune pancreatitis and the time course of renal function.
We report an elderly man with chronic tubulointerstitial nephritis (TIN) showing a high serum immunoglobulin G4 (IgG4) concentration. His serum creatinine (Scr) level had gradually increased from 0.9 mg/dL to 5.6 mg/dL over 18 months. Renal biopsy showed marked IgG4-positive plasma cell infiltration in the interstitium without glomerular abnormalities and IgG4-related TIN was diagnosed. Oral prednisolone reduced his Scr and IgG4 levels immediately. The present case indicates that IgG4-related TIN can not only progress rapidly but also chronically over a long period without significant urinary abnormalities, and we should consider hidden IgG4-related TIN in cases of chronic renal insufficiency.
Tsubata
Yutaka
Y
Department of Internal Medicine, Niigata Prefectural Central Hospital, Joetsu. tsubata.y@gmail.com
Akiyama
Fumihiro
F
Oya
Takeshi
T
Ajiro
Junya
J
Saeki
Takako
T
Nishi
Shinichi
S
Narita
Ichiei
I
D000368:Aged; D001327:Autoimmune Diseases / Q000097:blood / Q000175:diagnosis; D002908:Chronic Disease; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007668:Kidney / Q000502:physiology*; D007677:Kidney Function Tests / Q000639:trends; D008297:Male; D009395:Nephritis, Interstitial / Q000097:blood / Q000175:diagnosis*; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis; D013997:Time Factors
D007074:Immunoglobulin G