title: Remission of membranoproliferative glomerulonephritis associated with a noncirrhotic portosystemic shunt after percutaneous transhepatic portal vein embolization.
abstract: We present a case of a 75-year-old man with nephrotic syndrome and renal insufficiency caused by immune complex-mediated secondary membranoproliferative glomerulonephritis. He developed hepatic encephalopathy. A congenital portosystemic shunt was identified, indicating a diagnosis of membranoproliferative glomerulonephritis with noncirrhotic portosystemic shunt. Proteinuria resolved after shunt ratio reduction by percutaneous transhepatic portal vein embolization. Renal function and histopathological findings improved without immunosuppressive therapy. This case emphasizes the role of a high shunt ratio and reduced hepatic clearance of circulating immune complexes in such nephropathy. Membranoproliferative glomerulonephritis with a shunt may cause refractory nephrotic syndrome, but embolization is effective.
authors.affiliation: Department of Nephrology , Nippon Telegraph and Telephone East Corporation Sapporo Hospital.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Okamoto
authors.affiliation: Department of Nephrology , Nippon Telegraph and Telephone East Corporation Sapporo Hospital.
authors.forename: Sawako
authors.initials: S
authors.lastname: Fukazawa
authors.affiliation: Department of Nephrology , Nippon Telegraph and Telephone East Corporation Sapporo Hospital.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Shimamoto
authors.affiliation: Department of Nephrology , Nippon Telegraph and Telephone East Corporation Sapporo Hospital.
authors.forename: Rie
authors.initials: R
authors.lastname: Yamamoto
authors.affiliation: Department of Pathology , KKR Sapporo Medical Center , Sapporo 062-0931 , Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Fukazawa
keywords: cirrhosis-associated IgA nephropathy; membranoproliferative glomerulonephritis; noncirrhotic portosystemic shunt; percutaneous transhepatic portal vein embolization