title: Membranous nephropathy with repeated flares in IgG4-related disease.
abstract: IgG4-related disease (IgG4-RD) is associated with the infiltration of IgG4-positive plasma cells into various organs. Nephropathy of IgG4-RD is generally interstitial nephritis and glomerulonephritis is rare. We describe a case of membranous nephropathy (MN) without interstitial nephritis associated with IgG4-RD symptoms including lymphadenopathy and pulmonary and pleural lesions. Treatment with steroids improved these clinical symptoms, but withdrawal of steroids induced the repeated relapse of MN. Finally, flaring of MN was prevented by the combination of steroids and cyclosporine. This is the first report of the successful treatment of MN associated with IgG4-RD by this combination therapy.
authors: Department of Allergy and Rheumatology , University of Tokyo , Tokyo , Japan.
authors: Hiroko
authors: H
authors: Kanda
authors: Department of Hematology and Oncology , Graduate School of Medicine , University of Tokyo , Tokyo , Japan.
authors: Junji
authors: J
authors: Koya
authors: Department of Pathology , University of Tokyo , Tokyo , Japan.
authors: Hiroshi
authors: H
authors: Uozaki
authors: Department of Allergy and Rheumatology , University of Tokyo , Tokyo , Japan.
authors: Shoko
authors: S
authors: Tateishi
authors: Department of Rheumatology and Applied Immunology, Faculty of Medicine , Saitama Medical University , Saitama , Japan.
authors: Kojiro
authors: K
authors: Sato
authors: Department of Hematology and Rheumatology , Teikyo University Chiba Medical Center , Ichihara , Japan.
authors: Noboru
authors: N
authors: Hagino
authors: Department of Rheumatology , Tokyo Medical University Hospital , Tokyo , Japan.
authors: Tetsuji
authors: T
authors: Sawada
authors: Department of Allergy and Rheumatology , University of Tokyo , Tokyo , Japan.
authors: Kazuhiko
authors: K
authors: Yamamoto
keywords: IgG4-related disease; cyclophosphamide; cyclosporine A; flares; membranous nephropathy