Acute Renal Failure in Coexisting IgA Nephropathy and Acute Interstitial Nephritis: Complete Recovery after Hemodialysis and Steroid Therapy.
- Author:
Ju Hyun LEE
1
;
Ji Won RYU
;
Hyun Seok HONG
;
Joo Hark YI
;
Sang Woong HAN
;
Moon Hyang PARK
;
Ho Jung KIM
Author Information
1. Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea. cardion@hanyang.ac.kr
- Publication Type:Case Report
- Keywords:
IgA nephropathy;
Interstitial nephritis;
Acute renal failure;
Hematuria;
Proteinuria
- MeSH:
Acute Kidney Injury;
Adult;
Biopsy;
Glomerulonephritis;
Glomerulonephritis, IGA;
Hematuria;
Humans;
Immunoglobulin A;
Korea;
Necrosis;
Nephritis, Interstitial;
Proteinuria;
Renal Dialysis;
Renal Insufficiency;
Tin
- From:Korean Journal of Nephrology
2009;28(6):643-647
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Acute renal failure in Immunoglobulin A nephropathy (IgAN), a rare event, is associated with acute tubular necrosis mainly induced by intratubular erythrocytic cast and crescentic glomerulonephropathy (rapidly progressive glomerulonephritis) and the severity paralleled to the degree of glomerular damage. The changes are regarded as those of secondary atrophic response to the glomerular lesions. In that case, renal progression correlates more closely with the severity of tubulointerstitial lesions than with the degree of glomerular lesions in IgAN. Rarely, acute tubulointerstitial nephritis (TIN) could develop independently in primary glomerulonephritis. In this case, the severity of tubulointerstitial lesion was out of proportion with damage of glomerular lesion. To the best of our knowledge, we report the first case of a patient with independently developed severe acute TIN complicating IgAN in Korea. A 38-year-old man was admitted with recurrent hematuria. Proteinuria (<1 g) and severe renal failure were noted and hemodialysis was started. In renal biopsy, IgAN associated with acute TIN was diagnosed. He showed good response to steroid therapy and maintained normal renal function after discontinuation of medication.
