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KMID : 0882420140870010096
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Korean Journal of Medicine
2014 Volume.87 No. 1 p.96 ~ p.100
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IgG4-Related Tubulointerstitial Nephritis Accompanied by Henoch-Schonlein Purpura
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Yang Hyun
Choi Soo-Kyoung
Kim Bo-Kyoung
Yoo Ji-Yeon
Koh Eun-Sil
Chang Yoon-Sik
Chung Sung-Jin
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Abstract
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Tubulointerstitial nephritis is one of the common manifestations of immunoglobulin G (IgG)4-related disease; however, among all cases of tubulointerstitial nephritis undergoing renal biopsies, IgG4-related tubulointerstitial nephritis seems to be relatively rare because of its trivial urinary findings. A previously healthy 54-year-old man was referred to our clinic with a 4-week history of lower leg purpura and renal dysfunction. A kidney biopsy was planned because of bilateral renomegaly, by imaging studies, and elevated serum creatinine levels. Pathological findings in the kidney showed prominent infiltration of IgG4-postive plasma cells in the tubulointerstitium, but not the glumeruli. A skin biopsy revealed leukocytoclastic vasculitis, accompanied by deposition of IgA and C3 in the vascular wall, indicating Henoch-Schonlein purpura (HSP). Although cases of combined IgG4-related disease and microvasculitis, including HSP, are extremely rare, the possibility of an association between two diseases deserves attention.
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KEYWORD
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Immunoglobulin G4, Nephritis, Interstitial, Henoch-Schonlein purpura
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