Association of acute tubular necrosis with gross hematuria in cirrhosis-related immunoglobulin A nephropathy

• Main Authors: Jang Soo Han (Author), So Dug Lim (Author), Won Hyeok Choi (Author), Sung Chul Hong (Author), Jung Hee Park (Author), Eugene Park (Author), Mi Jin Hong (Author), Cho I Lee (Author), Jung Hwan Park (Author), Jong Ho Lee (Author), Jong Oh Song (Author), Young Il Jo (Author)
• Format: Book
• Published: The Korean Society of Nephrology, 2013-03-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

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.

Item Description

2211-9132
10.1016/j.krcp.2012.12.003