Nephrotic Syndrome due to Focal Segmental Glomerulosclerosis Complicating Sjögren’s Syndrome: A Case Report and Literature Review

Background. Renal tubular acidosis and tubulointerstitial nephritis constitute the primary renal complications associated with Sjögren’s syndrome (SjS), and glomerulonephritis and nephrotic syndrome are rare. Case Presentation. A 79-year-old Japanese woman presented with bilateral leg edema and weig...

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Main Authors: Shigekazu Kurihara, Makoto Harada, Tohru Ichikawa, Takashi Ehara, Mamoru Kobayashi
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Case Reports in Rheumatology
Online Access:http://dx.doi.org/10.1155/2019/1749795
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author Shigekazu Kurihara
Makoto Harada
Tohru Ichikawa
Takashi Ehara
Mamoru Kobayashi
author_facet Shigekazu Kurihara
Makoto Harada
Tohru Ichikawa
Takashi Ehara
Mamoru Kobayashi
author_sort Shigekazu Kurihara
collection DOAJ
description Background. Renal tubular acidosis and tubulointerstitial nephritis constitute the primary renal complications associated with Sjögren’s syndrome (SjS), and glomerulonephritis and nephrotic syndrome are rare. Case Presentation. A 79-year-old Japanese woman presented with bilateral leg edema and weight gain and was diagnosed with nephrotic syndrome. In addition, she reported a 5-year history of dryness of mouth and was diagnosed with SjS. Renal biopsy revealed segmental glomerulosclerosis, with some specimens showing collapse of the glomerular capillary loops, proliferation of glomerular epithelial cells, and sclerotic lesions at the tubular poles, without spike formation, double contour lesions, or any other changes of the glomerular basement membrane. Immunofluorescence staining showed no immune complex (immunoglobulin IgG, IgA, or IgM) or complement (C3) deposition in the glomerular capillary walls. Based on these findings, she was diagnosed with focal segmental glomerulosclerosis (FSGS). The administration of steroid and cyclosporine achieved complete remission of nephrotic syndrome. Conclusion. Although glomerular diseases are rare, a variety of glomerular lesions including FSGS are reported in patients with SjS. Therefore, renal biopsy is warranted in patients with SjS presenting with severe urinary abnormalities.
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series Case Reports in Rheumatology
spelling doaj-art-07694c4f7e2c4d2ba1942ec7e2f2c5f52025-08-20T03:55:28ZengWileyCase Reports in Rheumatology2090-68892090-68972019-01-01201910.1155/2019/17497951749795Nephrotic Syndrome due to Focal Segmental Glomerulosclerosis Complicating Sjögren’s Syndrome: A Case Report and Literature ReviewShigekazu Kurihara0Makoto Harada1Tohru Ichikawa2Takashi Ehara3Mamoru Kobayashi4Department of Nephrology, Nagano Red Cross Hospital, 5-22-1 Wakasato, Nagano 380-8582, JapanDepartment of Nephrology, Nagano Red Cross Hospital, 5-22-1 Wakasato, Nagano 380-8582, JapanDepartment of Nephrology, Nagano Red Cross Hospital, 5-22-1 Wakasato, Nagano 380-8582, JapanGraduate School of Health Sciences, Matsumoto University, 2095-1 Niimura, Matsumoto 390-1241, JapanDepartment of Nephrology, Nagano Red Cross Hospital, 5-22-1 Wakasato, Nagano 380-8582, JapanBackground. Renal tubular acidosis and tubulointerstitial nephritis constitute the primary renal complications associated with Sjögren’s syndrome (SjS), and glomerulonephritis and nephrotic syndrome are rare. Case Presentation. A 79-year-old Japanese woman presented with bilateral leg edema and weight gain and was diagnosed with nephrotic syndrome. In addition, she reported a 5-year history of dryness of mouth and was diagnosed with SjS. Renal biopsy revealed segmental glomerulosclerosis, with some specimens showing collapse of the glomerular capillary loops, proliferation of glomerular epithelial cells, and sclerotic lesions at the tubular poles, without spike formation, double contour lesions, or any other changes of the glomerular basement membrane. Immunofluorescence staining showed no immune complex (immunoglobulin IgG, IgA, or IgM) or complement (C3) deposition in the glomerular capillary walls. Based on these findings, she was diagnosed with focal segmental glomerulosclerosis (FSGS). The administration of steroid and cyclosporine achieved complete remission of nephrotic syndrome. Conclusion. Although glomerular diseases are rare, a variety of glomerular lesions including FSGS are reported in patients with SjS. Therefore, renal biopsy is warranted in patients with SjS presenting with severe urinary abnormalities.http://dx.doi.org/10.1155/2019/1749795
spellingShingle Shigekazu Kurihara
Makoto Harada
Tohru Ichikawa
Takashi Ehara
Mamoru Kobayashi
Nephrotic Syndrome due to Focal Segmental Glomerulosclerosis Complicating Sjögren’s Syndrome: A Case Report and Literature Review
Case Reports in Rheumatology
title Nephrotic Syndrome due to Focal Segmental Glomerulosclerosis Complicating Sjögren’s Syndrome: A Case Report and Literature Review
title_full Nephrotic Syndrome due to Focal Segmental Glomerulosclerosis Complicating Sjögren’s Syndrome: A Case Report and Literature Review
title_fullStr Nephrotic Syndrome due to Focal Segmental Glomerulosclerosis Complicating Sjögren’s Syndrome: A Case Report and Literature Review
title_full_unstemmed Nephrotic Syndrome due to Focal Segmental Glomerulosclerosis Complicating Sjögren’s Syndrome: A Case Report and Literature Review
title_short Nephrotic Syndrome due to Focal Segmental Glomerulosclerosis Complicating Sjögren’s Syndrome: A Case Report and Literature Review
title_sort nephrotic syndrome due to focal segmental glomerulosclerosis complicating sjogren s syndrome a case report and literature review
url http://dx.doi.org/10.1155/2019/1749795
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