Membranoproliferative glomerulonephritis following tubulointerstitial nephritis is a late manifestation of IgG4-related kidney disease: A distinctive case

• Main Authors: Joichi Usui (Author), Steven P. Salvatore (Author), Mourhege Alsaloum (Author), Alla Goldberg (Author), Sheng Kuo (Author), Surya V. Seshan (Author)
• Format: Book
• Published: Elsevier, 2019-11-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

IgG4-related kidney disease (IgG4RKD) generally presents as an active and chronic fibrosing tubulointerstitial nephritis. Recent reports have described glomerular lesions, typically with IgG4 containing subepithelial/membranous deposits as part of IgG4RKD. Herein, we report a case of IgG4-related membranoproliferative glomerulonephritis and associated tubulointerstitial nephritis in the clinical setting of IgG4-related autoimmune disease. A 75-year-old male diabetic patient with renal dysfunction showed IgG4-related tubulointersitital nephritis (TIN) superimposed on mild diabetic nephropathy by renal biopsy and was on 2 months of steroid therapy. Three years later, he developed progressive renal failure and heavy proteinuria leading to a second biopsy which showed, IgG4-dominant membranoproliferative pattern of glomerulonephritis (MPGN) along with chronic fibrosing IgG4-related tubulointerstitial disease. The development of MPGN is a rare lesion in association with IgG4 related TIN and may represent a late manifestation of IgG4RKD or continued complement activation. Keywords: Membranoproliferative glomerulonephritis, IgG4-related kidney disease, Tubulointerstitial nephritis, Diabetic nephropathy

Item Description

2214-3300
10.1016/j.ehpc.2019.200331