Agrawal V, Kaul A, Ranade R S, Sharma R K
Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Indian J Nephrol. 2015 May-Jun;25(3):168-70. doi: 10.4103/0971-4065.145425.
Immunoglobulin A (IgA) dominant membranoproliferative glomerulonephritis (MPGN) is rare, described only as case reports. We report a rare case of an elderly man presenting with rapidly progressive renal failure and nephrotic range proteinuria with histological, immunofluorescence, and ultrastructural findings supporting a diagnosis of IgA dominant MPGN. Autoimmune disease, cryoglobulinemia and infection-associated glomerulonephritis were excluded. Remission was achieved within 3 months of treatment. This case highlights an uncommon diagnosis with a good response to therapy. The differential diagnosis of IgA nephropathy with MPGN-like pattern is discussed.
免疫球蛋白A(IgA)为主的膜增生性肾小球肾炎(MPGN)较为罕见,仅有病例报告。我们报告1例罕见的老年男性病例,其表现为快速进展性肾衰竭和肾病范围蛋白尿,组织学、免疫荧光及超微结构检查结果支持IgA为主的MPGN诊断。排除了自身免疫性疾病、冷球蛋白血症及感染相关性肾小球肾炎。治疗3个月内病情缓解。该病例突出了一种不常见的诊断且对治疗反应良好。讨论了IgA肾病伴MPGN样表现的鉴别诊断。