title: Association of acute tubular necrosis with gross hematuria in cirrhosis-related immunoglobulin A nephropathy.
abstract: Immunoglobulin A (IgA) nephropathy associated with cirrhosis is the most common form of secondary IgA nephropathy (IgAN). Cirrhosis-related IgAN is usually clinically silent with a rare occurrence of gross hematuria, unlike in cases of idiopathic IgAN. Especially, acute tubular necrosis (ATN) associated with gross hematuria is very rare in cirrhosis-related IgAN, although acute renal failure is a frequently reported complication in advanced cirrhosis. Herein, we report an unusual case of ATN requiring renal replacement therapy, associated with gross hematuria in a patient with nonalcoholic, hepatitis B virus-associated cirrhosis. Results of a histopathological analysis revealed obstruction of the lumen of renal tubules by red blood cell casts, a marked tubular necrosis, and IgA deposition in the mesangium. The patient's renal function and gross hematuria were clearly improved after lamivudine treatment.
authors.affiliation: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Jang
authors.initials: J
authors.lastname: Soo Han
authors.affiliation: Department of Pathology, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: So
authors.initials: S
authors.lastname: Dug Lim
authors.affiliation: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Won
authors.initials: W
authors.lastname: Hyeok Choi
authors.affiliation: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Sung
authors.initials: S
authors.lastname: Chul Hong
authors.affiliation: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Jung
authors.initials: J
authors.lastname: Hee Park
authors.affiliation: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Eugene
authors.initials: E
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Mi
authors.initials: M
authors.lastname: Jin Hong
authors.affiliation: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Cho I
authors.initials: CI
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Jung
authors.initials: J
authors.lastname: Hwan Park
authors.affiliation: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Jong
authors.initials: J
authors.lastname: Ho Lee
authors.affiliation: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Jong
authors.initials: J
authors.lastname: Oh Song
authors.affiliation: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Young
authors.initials: Y
authors.lastname: Il Jo
keywords: Cirrhosis; Hematuria; Lamivudine; Renal failure