A Case of IgA Nephropathy with a Membranoproliferative Glomerulonephritis-like Pattern Presenting as Massive Ascites in a Patient with Alcoholic Liver Disease.
- Author:
Sun Ok SONG
1
;
Seung Won LEE
;
Hee Woo LEE
;
Beo Deul KANG
;
Shi Heon DONG
;
Ja Sung CHOI
;
Ji Sun SONG
;
Soo Young YOON
;
Sang Choel LEE
Author Information
1. Department of Internal Medicine, Kwandong University College of Medicine, Goyang, Korea. drjoy@kd.ac.kr
- Publication Type:Original Article
- Keywords:
IgA nephropathy;
Membranoproliferative glomerulonephritis;
Ascites;
Alcoholic liver disease
- MeSH:
Alcoholics;
Ascites;
Autopsy;
Azotemia;
Biopsy;
Capillaries;
Fluorescent Antibody Technique;
Glomerulonephritis;
Glomerulonephritis, IGA;
Glomerulonephritis, Membranoproliferative;
Hematuria;
Humans;
Hyperlipidemias;
Immunoglobulin A;
Liver;
Liver Cirrhosis;
Liver Cirrhosis, Alcoholic;
Liver Diseases, Alcoholic;
Male;
Middle Aged;
Nephritis;
Proteinuria;
Splenomegaly
- From:Korean Journal of Nephrology
2009;28(2):152-156
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
IgA nephropathy can occur commonly in alcoholic liver cirrhosis and is the most common form of secondary IgA nephropathy. Defective clearance of IgA-containing complexes by liver is thought to contribute to the development of IgA nephropathy in alcoholic cirrhosis. Although IgA deposition is found up to 64% in autopsy cases of alcoholic cirrhosis, most patients have mild clinical symptoms, and nephrotic range proteinuria occurs rarely in these patients. We report a case of IgA nephropathy with a membranoproliferative pattern that is detected with unusual massive ascites in a patient with alcoholic liver disease. A 60-year-old male patient was referred to our hospital for evaluation and management of abdominal distension. Abdominal ultrasonographic findings were compatible with diffuse liver cirrhosis with splenomegaly and large amount of ascites. He had nephrotic range proteinuria, azotemia, hyperlipidemia, and hematuria in dipstick. Renal biopsy performed under the impression of acute nephritis revealed mesangial and endocapillary proliferative glomerulonephritis with double contour of capillary loop. Immunofluorescence findings showed mesangial IgA and C3 deposit, compatible with IgA nephropathy. He was treated with high dose steroid, and steroid was tapered during 2 months. Steroid treatment induced complete remission state, and ascites was resolved.
