A case of rapidly progressive IgA nephropathy in a patient with exacerbation of Crohn's disease

Title
A case of rapidly progressive IgA nephropathy in a patient with exacerbation of Crohn's disease
Author(s)
김용진최지영[최지영]유청훈[유청훈]정희연[정희연]정민경[정민경]조장희[조장희]김찬덕[김찬덕]김영림[김영림]박선희[박선희]
Keywords
INFLAMMATORY-BOWEL-DISEASE; INTESTINAL PERMEABILITY; CELLS; COMPLICATIONS; ASSOCIATIONS; INCREASE; IL-17; ALPHA
Issue Date
201208
Publisher
BIOMED CENTRAL LTD
Citation
BMC NEPHROLOGY, v.13
Abstract
Background: IgA nephropathy has been reported as a renal involvement in Crohn's disease. Crescentic IgA nephropathy, which accounts for fewer than 5% of cases of IgA nephropathy, has a poorer prognosis than other forms of crescentic glomerulonephritis. We recently experienced a case of rapidly progressive IgA nephropathy concurrent with exacerbation of Crohn's disease. Case presentation: An 18-year-old male diagnosed with Crohn's disease underwent a hemicolectomy 2 years prior previously. He had maintained a state of Crohn's disease remission with 5-aminosalicylic acid treatment. Four months prior to referral to the nephrology clinic, he experienced non-bloody diarrhea. He simultaneously developed proteinuria and microscopic hematuria with deterioration of renal function. Based on renal biopsy findings, the patient was diagnosed with crescentic IgA nephropathy. Immunostaining for interleukin-17 in renal tissue and previous exacerbated colonic ulcers was positive. Steroid pulse therapy was administered, followed by high-dose glucocorticoid and oral cyclophosphamide therapy. The patient's renal function recovered and his gastrointestinal symptoms were alleviated. Conclusions: We report a case of crescentic IgA nephropathy presenting with exacerbation of Crohn's disease, and present a review of the literature focusing on the pathophysiologic relationship between these two conditions.
URI
http://hdl.handle.net/YU.REPOSITORY/27552http://dx.doi.org/10.1186/1471-2369-13-84
ISSN
1471-2369
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의과대학 > 병리학교실 > Articles
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