CEN Case Reports最新文献_第4页

A case of crystalglobulin-induced nephropathy wherein M protein was identified by mass spectrometry and immunoglobulin G subclass staining. 一例晶体球蛋白诱发的肾病，通过质谱分析和免疫球蛋白 G 亚类染色鉴定出了 M 蛋白。

IF 1

CEN Case Reports Pub Date : 2025-02-01 Epub Date: 2024-06-25 DOI: 10.1007/s13730-024-00906-x

Hibiki Mochida, Mizuki Kyoda, Yusuke Ushio, Taku Morito, Takahiro Kamiyama, Hideaki Oyagi, Akira Hirasawa, Naoki Hasegawa, Yukio Kakuta, Dedong Kang, Kazuho Honda, Sekiko Taneda, Michiyasu Hatano

引用次数: 0

Successful treatment of acute tubulointerstitial nephritis probably due to Benikoji CholesteHelp^®, a supplement containing red yeast rice. 成功治疗急性肾小管间质性肾炎，这可能归功于含有红麴的保健品 Benikoji CholesteHelp®。

IF 1

CEN Case Reports Pub Date : 2025-02-01 Epub Date: 2024-06-17 DOI: 10.1007/s13730-024-00897-9

Masayuki Maiguma, Masao Kihara, Maki Hamaguchi, Takashi Kobayashi, Koshi Yamada, Miyuki Takagi, Harumi Saeki, Tomohito Gohda, Yusuke Suzuki

{"title":"Successful treatment of acute tubulointerstitial nephritis probably due to Benikoji CholesteHelp®, a supplement containing red yeast rice.","authors":"Masayuki Maiguma, Masao Kihara, Maki Hamaguchi, Takashi Kobayashi, Koshi Yamada, Miyuki Takagi, Harumi Saeki, Tomohito Gohda, Yusuke Suzuki","doi":"10.1007/s13730-024-00897-9","DOIUrl":"10.1007/s13730-024-00897-9","url":null,"abstract":"Red yeast rice has been used to produce alcoholic beverages and various fermented foods especially in East Asia. Since around March 2024, there have been many cases of kidney dysfunction in people who have taken certain supplements containing red yeast rice in Japan. We experienced a case of acute kidney injuries induced after taking a supplement containing red yeast rice. A 58-year-old woman was admitted to our hospital due to renal dysfunction suspected to be caused by taking the supplement Benikoji CholesteHelp®, which contains red yeast rice. With elevations of urinary tubular injury markers such as urinary β2-microglobulin and N-acetyl-β-D-glucosaminidase, serum creatinine levels were elevated up to 2.75 mg/dL. A kidney biopsy revealed a diagnosis of tubulointerstitial nephritis with lymphocytic infiltration of the interstitium, tubular atrophy, and interstitial fibrotic changes. After discontinuation of the supplement and initiation of the prednisolone treatment, renal dysfunction rapidly improved. The course of this case suggests tubular damage caused by the supplements containing red yeast rice. For early diagnosis and treatment, it should be noted that even what are regarded as nutritional health supplements can cause renal dysfunction.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":" ","pages":"24-28"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

IF 1

CEN Case Reports Pub Date : 2025-02-01 Epub Date: 2024-06-04 DOI: 10.1007/s13730-024-00892-0

Yuki Horibe, Kazuaki Yamanaka, Junya Kaimori, Yuji Miyata, Shota Fukae, Takahiro Yoshida, Masahiro Nakagawa, Yasuki Ishihara, Miho Nagata, Yohei Miyashita, Yoshihiro Asano, Hidefumi Kishikawa

{"title":"MYH9-related disorder with sole presentation of end-stage kidney disease and long-term, recurrence-free living after living donor renal transplantation: a case report.","authors":"Yuki Horibe, Kazuaki Yamanaka, Junya Kaimori, Yuji Miyata, Shota Fukae, Takahiro Yoshida, Masahiro Nakagawa, Yasuki Ishihara, Miho Nagata, Yohei Miyashita, Yoshihiro Asano, Hidefumi Kishikawa","doi":"10.1007/s13730-024-00892-0","DOIUrl":"10.1007/s13730-024-00892-0","url":null,"abstract":"MYH9-related disorders are a group of autosomal dominant disorders caused by mutations in MYH9, and are characterized by thrombocytopenia, sensorineural hearing loss, cataracts, and renal failure. Here, we report a case of chronic renal failure due to MYH9-related disorder with renal symptoms in a patient who underwent living-donor renal transplantation. The patient was diagnosed with proteinuria during a health checkup at the age of 12 years. Her renal function gradually deteriorated, and hemodialysis was initiated at 34 years of age. No definitive diagnosis of renal disease was made through renal biopsy. At the age of 35, she underwent living-donor renal transplantation from her mother as the donor. Six years after transplantation, her renal function remained stable, and no evidence of recurrent nephritis was found during renal biopsies. The family history revealed that her father, uncle, and younger brother had end-stage kidney disease. Genetic testing revealed a mutation (p.E1653D) related to the MYH9 gene. As her father had a history of renal biopsy and was diagnosed with focal segmental glomerulosclerosis (FSGS), we diagnosed chronic renal failure due to FSGS associated with MYH9 disorder. There were no findings suggestive of hearing loss, cataracts, or thrombocytopenia in the recipient or their family members with renal failure, and no symptoms other than renal failure were noted.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":" ","pages":"11-15"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141236658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fanconi syndrome with karyomegalic interstitial nephritis after ifosfamide treatment for osteosarcoma: a case report. 伊佛酰胺治疗骨肉瘤后伴有巨核细胞间质性肾炎的范可尼综合征：病例报告。

IF 1

CEN Case Reports Pub Date : 2025-02-01 Epub Date: 2024-07-02 DOI: 10.1007/s13730-024-00907-w

Yohei Kita, Sayuri Shirai, Teppei Koyama, Ryuichiro Makinouchi, Shinji Machida, Katsuomi Matsui, Junki Koike, Naohiko Imai

{"title":"Fanconi syndrome with karyomegalic interstitial nephritis after ifosfamide treatment for osteosarcoma: a case report.","authors":"Yohei Kita, Sayuri Shirai, Teppei Koyama, Ryuichiro Makinouchi, Shinji Machida, Katsuomi Matsui, Junki Koike, Naohiko Imai","doi":"10.1007/s13730-024-00907-w","DOIUrl":"10.1007/s13730-024-00907-w","url":null,"abstract":"Patients with ifosfamide-induced renal damage present with Fanconi syndrome. Karyomegalic nephropathy/interstitial nephritis (KNIN) is a rare form of chronic tubulo-interstitial nephritis that was initially considered a type of familial nephropathy. However, several reports of drug-induced KNIN, i.e., KNIN-like nephropathy, have been reported in recent years. We present the case of an 18-year-old man who presented with Fanconi syndrome and progressive renal dysfunction after receiving chemotherapy including ifosfamide and cisplatin for right femoral osteosarcoma. Renal biopsy revealed numerous atrophied tubular epithelial cells with large, polymorphic nuclei, and the definitive diagnosis was KNIN. Most patients with KNIN-like nephropathy who receive ifosfamide are concomitantly treated with cisplatin, indicating that ifosfamide and cisplatin might act synergistically to increase the risk for KNIN-like nephropathy. Further investigation in case series is warranted to reveal potential treatment approaches and to evaluate prognosis.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":" ","pages":"65-70"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141491029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of Fanconi syndrome that developed following a year of consumption of a red yeast rice supplement. 一个范可尼综合征病例，在服用红麴补充剂一年后发病。

IF 1

CEN Case Reports Pub Date : 2025-02-01 Epub Date: 2024-07-10 DOI: 10.1007/s13730-024-00913-y

Yuki Kawai, Moe Ozawa, Aya Isomura, Hiroshi Mitsuhashi, Satoshi Yamaguchi, Shohei Nagayama, Shohei Tanaka, Eriko Abe, Sanae Saka, Kiyotaka Nagahama, Tamio Iwamoto, Kouichi Tamura

{"title":"A case of Fanconi syndrome that developed following a year of consumption of a red yeast rice supplement.","authors":"Yuki Kawai, Moe Ozawa, Aya Isomura, Hiroshi Mitsuhashi, Satoshi Yamaguchi, Shohei Nagayama, Shohei Tanaka, Eriko Abe, Sanae Saka, Kiyotaka Nagahama, Tamio Iwamoto, Kouichi Tamura","doi":"10.1007/s13730-024-00913-y","DOIUrl":"10.1007/s13730-024-00913-y","url":null,"abstract":"Although some dietary supplements have been reported to cause renal dysfunction, there have been few reports of supplement-induced Fanconi syndrome. We present the case of a 56-year-old woman with Fanconi syndrome that developed after she consumed a red yeast rice supplement. She was referred to our hospital because of renal dysfunction, and was found to have electrolyte abnormalities, including hypophosphatemia and hypouricemia, renal diabetes, and hyperchloremic metabolic acidosis, and was, therefore, diagnosed with Fanconi syndrome. Renal biopsy revealed proximal tubular injury characterized by severely degenerated tubular epithelial cells as well as mild hypocellular fibrosis. We speculated that the red yeast rice supplement, which the patient had been consuming for approximately 1 year, might be a cause of her syndrome, because reports of renal dysfunction associated with the consumption of red yeast rice supplements have emerged in Japan since 2024. After the supplement was discontinued and oral prednisolone treatment was initiated, the patient's renal function improved and her electrolyte abnormalities were ameliorated. Furthermore, even after tapering off and discontinuing the prednisolone over approximately 12 weeks, her renal function remained. Because Fanconi syndrome may be caused by various exogenous substances, the taking of a thorough medical history is crucial, including with respect to the use not only of prescription medications, but also other substances, including supplements.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":" ","pages":"95-102"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141562776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful use of avacopan in a case of ANCA-associated vasculitis with treatment-resistant medium-sized vessel involvement.

IF 1

CEN Case Reports Pub Date : 2025-01-24 DOI: 10.1007/s13730-025-00965-8

Takaaki Tsuchiya, Yui Ohta, Masatoshi Oka, Kaoruko Fukushima, Shiho Matsuno, Noriko Yamanaka, Noriyuki Suzuki, Wako Yumura, Akiko Komatsu, Tomio Arai, Takashi Takei, Mitsuyo Itabashi

{"title":"Successful use of avacopan in a case of ANCA-associated vasculitis with treatment-resistant medium-sized vessel involvement.","authors":"Takaaki Tsuchiya, Yui Ohta, Masatoshi Oka, Kaoruko Fukushima, Shiho Matsuno, Noriko Yamanaka, Noriyuki Suzuki, Wako Yumura, Akiko Komatsu, Tomio Arai, Takashi Takei, Mitsuyo Itabashi","doi":"10.1007/s13730-025-00965-8","DOIUrl":"https://doi.org/10.1007/s13730-025-00965-8","url":null,"abstract":"We report the case of a 75-year-old woman who presented with fever, right back pain, paresthesia in the right extremities, erythema, purpura, and nodules. She had previously initiated dialysis due to rapidly progressive glomerulonephritis and was transferred to our hospital. Imaging studies revealed multiple cerebral and splenic infarcts and hemorrhage encapsulating the right kidney, likely due to microaneurysms in multiple renal arteries. High MPO-ANCA titers were observed, and a skin biopsy revealed granulomatous inflammation affecting medium-sized vessels, leading to a diagnosis of granulomatosis with polyangiitis (GPA) and ANCA-associated vasculitis (AAV) involving medium-sized vessels. Treatment began with intravenous pulse steroid therapy (methylprednisolone 1000 mg/day) and subsequent oral prednisolone (PSL) 40 mg (about 0.8 mg/kg) and intravenous cyclophosphamide (IVCY) at 250 mg. While her symptoms improved, she developed severe infections, including candidemia and febrile neutropenia. Consequently, we combined PSL with the C5a receptor antagonist avacopan, which allowed for PSL tapering and stabilized her disease. This case is significant as no previous reports of avacopan's efficacy in AAV with medium-sized vessel involvement suggest its potential effectiveness in such cases.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An educational case of toluene intoxication: importance of kidney function and timing in diagnosis.

IF 1

CEN Case Reports Pub Date : 2025-01-22 DOI: 10.1007/s13730-025-00964-9

Masatomo Ogata, Naoto Tominaga, Satoru Morikubo, Tomohiko Inoue, Yugo Shibagaki, Masahiko Yazawa

{"title":"An educational case of toluene intoxication: importance of kidney function and timing in diagnosis.","authors":"Masatomo Ogata, Naoto Tominaga, Satoru Morikubo, Tomohiko Inoue, Yugo Shibagaki, Masahiko Yazawa","doi":"10.1007/s13730-025-00964-9","DOIUrl":"https://doi.org/10.1007/s13730-025-00964-9","url":null,"abstract":"Metabolic acidosis (MA) is common in daily clinical settings and requires evaluation not only by serum anion gap (AG) but also by urine AG (UAG) and urine osmolal gap (UOG) to investigate potential causes and determine appropriate treatment. Herein, we report an educational case of non-gap (normal AG) MA (pH 7.16, HCO3- 8.4, AG 11.6) with nausea and fatigue. The patient had three episodes of hospital admission with MA in the previous three months. Although serum lactate and ketone levels were negative, the AG levels were notably inconsistent (elevated or not) each time. Nevertheless, the patient was suspected to have toluene intoxication because of low UAG and high UOG levels in the non-gap acidosis phase. Eventually, he was diagnosed with toluene intoxication due to a significantly elevated urinary hippurate level (28.7 g/L) despite never admitting to using toluene. Additionally, he had a high AG only in the presence of significant kidney dysfunction, which suggests that the high AG was either due to kidney dysfunction or accumulated hippurate in the blood (when UOG was high). Thus, it should be noted that the use of serum AG alone may lead to incorrect determination of cause(s) of MA when kidney dysfunction coexists, and that UAG and UOG, in addition to AG, are necessary to determine correct diagnosis.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of mucormycosis caused by Rhizopus microsporus in a renal transplant patient. 肾移植患者小孢子根霉引起毛霉病1例。

IF 1

CEN Case Reports Pub Date : 2025-01-20 DOI: 10.1007/s13730-025-00969-4

Miruzato Fukuda, Takayoshi Yokoyama, Morota Marie, Katsuyuki Miki, Masayuki Yamanouchi, Hiroki Mizuno, Yuki Oba, Noriko Inoue, Akinari Sekine, Kiho Tanaka, Eiko Hasegawa, Tatsuya Suwabe, Takehiko Wada, Kei Kono, Kenichi Ohashi, Yutaka Yamaguchi, Sho Ogura, Naoki Sawa, Yuki Nakamura, Yasuo Ishii, Yoshifumi Ubara

{"title":"A case of mucormycosis caused by Rhizopus microsporus in a renal transplant patient.","authors":"Miruzato Fukuda, Takayoshi Yokoyama, Morota Marie, Katsuyuki Miki, Masayuki Yamanouchi, Hiroki Mizuno, Yuki Oba, Noriko Inoue, Akinari Sekine, Kiho Tanaka, Eiko Hasegawa, Tatsuya Suwabe, Takehiko Wada, Kei Kono, Kenichi Ohashi, Yutaka Yamaguchi, Sho Ogura, Naoki Sawa, Yuki Nakamura, Yasuo Ishii, Yoshifumi Ubara","doi":"10.1007/s13730-025-00969-4","DOIUrl":"https://doi.org/10.1007/s13730-025-00969-4","url":null,"abstract":"A 54-year-old man who had been on the kidney donor register for 32 years received a kidney from a 9-year-old boy who had died of fulminant myocarditis. The post-operative course was poor, and hemodialysis was still needed after surgery. A kidney biopsy one hour after surgery showed a neutrophil-predominant inflammatory cell infiltrate localized to the peritubular capillaries (PTC) and acute tubular necrosis of the proximal tubule. Rhizopus species was detected in a perirenal white exudate taken 29 days postoperatively, and the transplanted kidney was removed on postoperative day 45. The removed kidney showed fungal collection formation localized in the arteries and endotheliitis and embolization of the arteries. Renal damage caused by mucormycosis due to Rhizopus microspores was diagnosed. Mucormycosis is a fungal infection with a strong vascular affinity that develops along the vascular wall but does not extend beyond it. The infection leads to arterial infarction and organ failure. This report presents a rare case in which mucormycosis, which had been nested within the peritubular capillaries of the donor kidney, proliferated under immunosuppressive treatment but did so only in the artery, leading to infarction of the kidney. Neutrophilic collections within the PTC on one hour biopsy may be helpful in the early diagnosis of fungal infections.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Steroid-resistant nephrotic syndrome as paraneoplastic syndrome of Waldenström macroglobulinemia: a case report. 类固醇抵抗性肾病综合征作为Waldenström巨球蛋白血症的副肿瘤综合征1例。

IF 1

CEN Case Reports Pub Date : 2025-01-14 DOI: 10.1007/s13730-025-00968-5

Konosuke Hirano, Sayuri Shirai, Teppei Koyama, Ryuichiro Makinouchi, Shinji Machida, Katsuomi Matsui, Shigeki Kosugi, Yasushi Ariizumi, Yukiko Kanetsuna, Junki Koike, Naohiko Imai

{"title":"Steroid-resistant nephrotic syndrome as paraneoplastic syndrome of Waldenström macroglobulinemia: a case report.","authors":"Konosuke Hirano, Sayuri Shirai, Teppei Koyama, Ryuichiro Makinouchi, Shinji Machida, Katsuomi Matsui, Shigeki Kosugi, Yasushi Ariizumi, Yukiko Kanetsuna, Junki Koike, Naohiko Imai","doi":"10.1007/s13730-025-00968-5","DOIUrl":"https://doi.org/10.1007/s13730-025-00968-5","url":null,"abstract":"Reports of glomerulonephritis associated with lymphoproliferative disorders are common, but reports of minimal change disease (MCD) accompanying non-Hodgkin's lymphoma are rare. Here, we present a case of a 45-year-old woman diagnosed with primary Waldenström's macroglobulinemia (WM) during MCD treatment. Her kidney biopsy revealed endothelial cell injury in parts of the MCD. Subsequently, she developed steroid-resistant nephrotic syndrome and temporary acute kidney injury, requiring dialysis. Remission of the nephrotic syndrome was achieved after initiating combination therapy with bendamustine and rituximab for WM. The renal histological findings and treatment course suggest a causal relationship between MCD and WM in this case. The pathogenesis of MCD associated with WM may involve the release of glomerular permeability factors derived from B lymphocytes. Although mild WM is often managed with observation, steroid-resistant nephrotic syndrome associated with WM should raise suspicion of a paraneoplastic syndrome, necessitating active chemotherapy targeting WM as a critical treatment approach.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

IgA vasculitis with nephritis accompanied by pulmonary tuberculosis: a case report. IgA血管炎伴肾炎并发肺结核1例。

IF 1

CEN Case Reports Pub Date : 2025-01-09 DOI: 10.1007/s13730-025-00966-7

Eriko Abe, Ryu Kobayashi, Rio Matsuoka, Tomohiko Kanaoka, Shoji Yamanaka, Satoshi Fujii, Junki Koike, Takashi Oda, Hiromichi Wakui, Kouichi Tamura

{"title":"IgA vasculitis with nephritis accompanied by pulmonary tuberculosis: a case report.","authors":"Eriko Abe, Ryu Kobayashi, Rio Matsuoka, Tomohiko Kanaoka, Shoji Yamanaka, Satoshi Fujii, Junki Koike, Takashi Oda, Hiromichi Wakui, Kouichi Tamura","doi":"10.1007/s13730-025-00966-7","DOIUrl":"https://doi.org/10.1007/s13730-025-00966-7","url":null,"abstract":"A 69-year-old Japanese man developed abdominal pain, purpura, proteinuria, and hematuria while receiving treatment for pulmonary tuberculosis. A skin biopsy revealed IgA-positive leukocytoclastic vasculitis, and a renal biopsy showed IgA-positive mesangial proliferative glomerulonephritis with crescent formation. Based on these findings, we diagnosed IgA vasculitis with nephritis (IgAVN) and initiated treatment. The patient's abdominal symptoms improved following factor XIII supplementation and corticosteroids. Corticosteroids were administered, and after 5 months, the proteinuria was in complete remission. Although IgAVN often follows a prior infection, it is rarely complicated by tuberculosis. In this case, staining for galactose-deficient IgA1, which is specifically positive in IgA nephropathy and IgAVN, was positive. Nephritis-associated plasmin receptor staining was also positive, suggesting some involvement of infectious glomerulonephritis. Therefore, the patient was considered to have IgAVN associated with pulmonary tuberculosis. In adult-onset cases, IgAVN is often severe. This patient was presented with adult-onset nephrosis and International Study of Kidney Disease in Children grade IIIb IgAVN, suggesting a poor prognosis. Therefore, we immediately initiated treatment with corticosteroids, factor XIII supplementation, a renin-aldosterone-system inhibitor, and a sodium-glucose cotransporter 2 inhibitor. The patient recovered uneventfully with no worsening of tuberculosis.","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0