A Case of IgA Nephropathy with Systemic Lupus Nephritis.
- Author:
Kweon Woo HAN
1
;
Young Ki LEE
;
Hae Ri LEE
;
Sang Ik HWANG
;
Seong Gyun KIM
;
Ji Eun OH
;
Jang Won SEO
;
Ja Ryong KOO
;
Hyung Jik KIM
;
Jung Woo NOH
;
Chong Woo YOO
;
Eun Sook NAM
Author Information
1. Department of Internal Medicine, College of Medicine, Hallym University, Seoul, Korea. km2071@unitel.co.kr
- Publication Type:Case Report
- Keywords:
IgA nephropathy;
SLE;
Nephrotic syndrome
- MeSH:
Adult;
Arthralgia;
Biopsy;
Complement System Proteins;
Diagnosis;
DNA;
Edema;
Female;
Glomerulonephritis, IGA*;
Hematologic Tests;
Humans;
Immunoglobulin A*;
Immunoglobulin G;
Immunoglobulin M;
Immunoglobulins;
Lupus Erythematosus, Systemic;
Lupus Nephritis*;
Microscopy, Electron;
Microscopy, Fluorescence;
Nephrotic Syndrome;
Prednisolone;
Pregnant Women;
Proteinuria;
Thrombocytopenia
- From:Korean Journal of Nephrology
2005;24(2):326-331
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Renal involvement is common in systemic lupus erythematosus (SLE). The typical lupus nephropathy demonstrates polyclonal immunoglobulin immune deposits with predominance of IgG, usually heavy polytypic complement factors C1q, C3 and C4. In SLE patients, the superimposition and occurrence of non- lupus nephropathy have rarely been reported. We describe a 28-year-old, 15 weeks pregnant women affected by SLE and IgA nephropathy. She was admitted to our hospital due to generalized edema and arthralgia. The ANA titer was 1: 640, anti-ds DNA levels were 354.2 U/mL and other blood tests included thrombocytopenia and hypoclomplementemia. These clinical and laboratory data allowed the diagnosis of SLE. Renal biopsy showed modest segmental mesangial hypercellularity. Immunofluorescence microscopy revealed distinct mesangial IgA and C3 with absence of IgG, IgM, C1q, and C4. Electron microscopy confirmed the presence of electron-dense deposits throughout the mesangium. These features were consistent with the coexistence of IgA nephropathy. A course of prednisolone (50 mg/day) was given for six months and she responded well with resolution of proteinuria. At the present follow- up time point (48 months), she continues to be treated with prednisolone (5 mg/day); proteinuria and ANA are undetectable.
