A Refractory Case of Secondary Membranous Nephropathy Concurrent with IgG4-related Tubulointerstitial Nephritis.
A Refractory Case of Secondary Membranous Nephropathy Concurrent with IgG4-related Tubulointerstitial Nephritis.
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DOI：
10.2169/internalmedicine.0836-18
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发表时间：
2018-10-01
期刊：
影响因子：
--
通讯作者：
Yanagita M
中科院分区：
文献类型：
--
作者：
Arai H;Toda N;Kamimatsuse R;Nishioka K;Endo S;Akiyama S;Maruyama S;Matsubara T;Yokoi H;Yanagita M
一名58岁的1型自身免疫性胰腺炎患者因严重蛋白尿被转诊到肾病科。实验室数据显示血清IgG4水平高，低白蛋白血症和大量蛋白尿，与肾病综合征相符。肾脏病理结果证实继发性膜性肾病并发igg4相关性小管间质性肾炎。尽管间质标志物有所改善，但蛋白尿对强的松龙是难治性的，需要环孢素才能达到完全缓解。膜性肾病是一种罕见的与igg4相关的肾脏疾病。本病例显示，igg4相关肾病的肾小球病变和间质病变对强的松龙的治疗反应有显著差异。
A 58-year-old man with type 1 autoimmune pancreatitis was referred to nephrologists for severe proteinuria. Laboratory data revealed a high serum IgG4 level, hypoalbuminemia, and massive proteinuria, which were compatible with nephrotic syndrome. The renal pathological findings confirmed the diagnosis of secondary membranous nephropathy concurrent with IgG4-related tubulointerstitial nephritis. Despite the improvement of interstitial markers, the proteinuria was refractory to prednisolone, requiring cyclosporine to achieve complete remission. Membranous nephropathy is a rare manifestation of IgG4-related kidney disease. This case shows that the therapeutic response to prednisolone significantly differs between glomerular lesions and interstitial lesions of IgG4-related kidney disease.
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影响因子：
1
作者：
Sueta S;Kondo M;Matsubara T;Yasuhara Y;Akiyama S;Imai E;Amaike H;Tagawa M
通讯作者：
Tagawa M
影响因子：
19.6
作者：
Alexander, Mariam P.;Larsen, Christopher P.;Cornell, Lynn D.
通讯作者：
Cornell, Lynn D.
影响因子：
2.3
作者：
Khosroshahi A;Ayalon R;Beck LH Jr;Salant DJ;Bloch DB;Stone JH
通讯作者：
Stone JH
影响因子：
3.7
作者：
Hihara K;Iyoda M;Tachibana S;Iseri K;Saito T;Yamamoto Y;Suzuki T;Wada Y;Matsumoto K;Shibata T
通讯作者：
Shibata T
影响因子：
--
作者：
Khosroshahi, Arezou;Bloch, Donald B.;Stone, John H.
通讯作者：
Stone, John H.