A Retrospectively Diagnosed Case of IgG4-Related Tubulointerstitial Nephritis Showing Good Renal Outcome and Pathological Progress
A 74-year-old man was hospitalized for diabetic nephropathy evaluation and assessment of the effect of treatment on his tubulointerstitial nephritis (TIN). When he was 62 years old, he developed polyarthralgia and had superficial lymph node swelling, mildly increased serum creatinine concentration,...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2013/953214 |
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| author | Qiong Wu Raima Nakazawa Hisae Tanaka Masayuki Endoh Masafumi Fukagawa |
| author_facet | Qiong Wu Raima Nakazawa Hisae Tanaka Masayuki Endoh Masafumi Fukagawa |
| author_sort | Qiong Wu |
| collection | DOAJ |
| description | A 74-year-old man was hospitalized for diabetic nephropathy evaluation and assessment of the effect of treatment on his tubulointerstitial nephritis (TIN). When he was 62 years old, he developed polyarthralgia and had superficial lymph node swelling, mildly increased serum creatinine concentration, hypergammaglobulinemia, hypocomplementemia, high serum IL-2R level, and positive titer of antinuclear antibody. Several tissues were biopsied. Mild chronic sialadenitis and reactive lymphadenitis were identified. Renal specimen showed mild glomerular ischemia, extensive storiform fibrosis, and abundant infiltrating monocytes and plasma cells. He was treated with oral prednisolone and cyclophosphamide. After the treatment, most of his clinical parameters quickly returned to within the reference range. However, he developed diabetes mellitus soon after steroid therapy. At the time of rebiopsy, a high level of serum IgG4 was detected. The second renal biopsy showed diabetic nephropathy without any tubulointerstitial damage. The first biopsied tissues were retrospectively investigated. Large numbers of IgG4-positive plasma cells were detected in the kidneys and lymph nodes. A retrospective diagnosis of IgG4-related TIN with lymph node involvement was made. In conclusion, this paper describes a retrospectively diagnosed case of IgG4-related TIN with lymph node involvement, showing good clinical and pathological prognosis. |
| format | Article |
| id | doaj-art-92b60ccffba748528a0e2245df125366 |
| institution | OA Journals |
| issn | 2090-6641 2090-665X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Nephrology |
| spelling | doaj-art-92b60ccffba748528a0e2245df1253662025-08-20T02:09:55ZengWileyCase Reports in Nephrology2090-66412090-665X2013-01-01201310.1155/2013/953214953214A Retrospectively Diagnosed Case of IgG4-Related Tubulointerstitial Nephritis Showing Good Renal Outcome and Pathological ProgressQiong Wu0Raima Nakazawa1Hisae Tanaka2Masayuki Endoh3Masafumi Fukagawa4Department of Internal Medicine, School of Medicine, Tokai University, Kanagawa, Isehara 259-1193, JapanDepartment of Internal Medicine, School of Medicine, Tokai University, Kanagawa, Isehara 259-1193, JapanDepartment of Internal Medicine, School of Medicine, Tokai University, Kanagawa, Isehara 259-1193, JapanDepartment of Internal Medicine, School of Medicine, Tokai University, Kanagawa, Isehara 259-1193, JapanDepartment of Internal Medicine, School of Medicine, Tokai University, Kanagawa, Isehara 259-1193, JapanA 74-year-old man was hospitalized for diabetic nephropathy evaluation and assessment of the effect of treatment on his tubulointerstitial nephritis (TIN). When he was 62 years old, he developed polyarthralgia and had superficial lymph node swelling, mildly increased serum creatinine concentration, hypergammaglobulinemia, hypocomplementemia, high serum IL-2R level, and positive titer of antinuclear antibody. Several tissues were biopsied. Mild chronic sialadenitis and reactive lymphadenitis were identified. Renal specimen showed mild glomerular ischemia, extensive storiform fibrosis, and abundant infiltrating monocytes and plasma cells. He was treated with oral prednisolone and cyclophosphamide. After the treatment, most of his clinical parameters quickly returned to within the reference range. However, he developed diabetes mellitus soon after steroid therapy. At the time of rebiopsy, a high level of serum IgG4 was detected. The second renal biopsy showed diabetic nephropathy without any tubulointerstitial damage. The first biopsied tissues were retrospectively investigated. Large numbers of IgG4-positive plasma cells were detected in the kidneys and lymph nodes. A retrospective diagnosis of IgG4-related TIN with lymph node involvement was made. In conclusion, this paper describes a retrospectively diagnosed case of IgG4-related TIN with lymph node involvement, showing good clinical and pathological prognosis.http://dx.doi.org/10.1155/2013/953214 |
| spellingShingle | Qiong Wu Raima Nakazawa Hisae Tanaka Masayuki Endoh Masafumi Fukagawa A Retrospectively Diagnosed Case of IgG4-Related Tubulointerstitial Nephritis Showing Good Renal Outcome and Pathological Progress Case Reports in Nephrology |
| title | A Retrospectively Diagnosed Case of IgG4-Related Tubulointerstitial Nephritis Showing Good Renal Outcome and Pathological Progress |
| title_full | A Retrospectively Diagnosed Case of IgG4-Related Tubulointerstitial Nephritis Showing Good Renal Outcome and Pathological Progress |
| title_fullStr | A Retrospectively Diagnosed Case of IgG4-Related Tubulointerstitial Nephritis Showing Good Renal Outcome and Pathological Progress |
| title_full_unstemmed | A Retrospectively Diagnosed Case of IgG4-Related Tubulointerstitial Nephritis Showing Good Renal Outcome and Pathological Progress |
| title_short | A Retrospectively Diagnosed Case of IgG4-Related Tubulointerstitial Nephritis Showing Good Renal Outcome and Pathological Progress |
| title_sort | retrospectively diagnosed case of igg4 related tubulointerstitial nephritis showing good renal outcome and pathological progress |
| url | http://dx.doi.org/10.1155/2013/953214 |
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