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KMID : 1039420160500010026
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Journal of Pathology and Translational Medicine
2016 Volume.50 No. 1 p.26 ~ p.36
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Overview of IgG4-Related Tubulointerstitial Nephritis and Its Mimickers
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Jeong Hyeon-Joo
Shin Su-Jin
Lim Beom-Jin
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Abstract
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Tubulointerstitial nephritis (TIN) is the most common form of renal involvement in IgG4-related disease. It is characterized by a dominant infiltrate of IgG4-positive plasma cells in the interstitium and storiform fibrosis. Demonstration of IgG4-positive plasma cells is essential for diagnosis, but the number of IgG4-positive cells and the ratio of IgG4-positive/IgG-positive plasma cells may vary from case to case and depending on the methods of tissue sampling even in the same case. IgG4-positive plasma cells can be seen in TIN associated with systemic lupus erythematosus, Sjogren syndrome, or anti-neutrophil cytoplasmic antibody?associated vasculitis, which further add diagnostic confusion and difficulties. To have a more clear view of IgG4-TIN and to delineate differential points from other TIN with IgG4-positive plasma cell infiltrates, clinical and histological features of IgG4-TIN and its mimickers were reviewed. In the rear part, cases suggesting overlap of IgG4-TIN and its mimickers and glomerulonephritis associated with IgG4-TIN were briefly described.
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KEYWORD
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IgG4-related disease, Lupus nephritis, Sjogren’s syndrome, Anti-neutrophil cytoplasmic antibody-associated vasculitis, Glomerulonephritis, membranous
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