Tateno S, Kobayashi Y, Kobayashi F
Department of Medicine, School of Medicine, Kitasato University, Sagamihara, Japan.
Pathol Int. 1994 May;44(5):387-90. doi: 10.1111/j.1440-1827.1994.tb02939.x.
A 36 year old man, who had been proteinuric for 14 years due to immunoglobulin A (IgA) nephropathy, was admitted because of an acute exacerbation in renal dysfunction with hypercalcemia. He had presented with aortic regurgitation and increased pulmonary marking by chest X-ray, but laboratory examinations had failed to make an exact diagnosis. On admission, noncaseating epithelioid granulomas were disclosed by muscle and skin biopsies. Ophthalmological evaluation revealed old uveitis and retinal changes consistent with sarcoidosis. In this case, IgA nephropathy was thought to be the initial manifestation of sarcoidosis that developed latently. Sarcoidosis should be considered in a differential diagnosis of IgA nephropathy.
一名36岁男性，因免疫球蛋白A（IgA）肾病蛋白尿已达14年，因肾功能急性恶化伴高钙血症入院。他曾出现主动脉瓣关闭不全，胸部X线显示肺纹理增多，但实验室检查未能明确诊断。入院时，肌肉和皮肤活检发现非干酪样上皮样肉芽肿。眼科评估显示陈旧性葡萄膜炎和与结节病相符的视网膜改变。在该病例中，IgA肾病被认为是潜在发展的结节病的初始表现。在IgA肾病的鉴别诊断中应考虑结节病。
