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Idiopathic membranous nephropathy in a patient diagnosed with IgG4-related disease: A case report

RATIONALE: Immunoglobulin (Ig) G4-related disease (IgG4-RD) is a newly recognized, systemic disease. Membranous nephropathy is the most common glomerular lesion in IgG4- related kidney disease. However, the lack of relationship with IgG4-related kidney disease and monoclonal gammopathy of undetermin...

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Autores principales: Ma, XiaoYing, Xu, HaiPing, Sun, Jing Yi, Gedara, Yuresha Surangani Siyabalagaba, Sun, FuYun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571987/
https://www.ncbi.nlm.nih.gov/pubmed/33080759
http://dx.doi.org/10.1097/MD.0000000000022817
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author Ma, XiaoYing
Xu, HaiPing
Sun, Jing Yi
Gedara, Yuresha Surangani Siyabalagaba
Sun, FuYun
author_facet Ma, XiaoYing
Xu, HaiPing
Sun, Jing Yi
Gedara, Yuresha Surangani Siyabalagaba
Sun, FuYun
author_sort Ma, XiaoYing
collection PubMed
description RATIONALE: Immunoglobulin (Ig) G4-related disease (IgG4-RD) is a newly recognized, systemic disease. Membranous nephropathy is the most common glomerular lesion in IgG4- related kidney disease. However, the lack of relationship with IgG4-related kidney disease and monoclonal gammopathy of undetermined significance (MGUS) warrants investigation of the potential mechanisms. PATIENT CONCERNS: A 62-year-old patient was diagnosed with IgG4-RD, tubulointerstitial nephritis, retroperitoneal fibrosis. After 2 years, she was presented with proteinuria, hypoproteinemia, facial, and bilateral lower limb edema. Furthermore, this patient exhibited deposits of IgG k of monoclonal hyperplasia, and bone marrow plasma cell count was 2.5%. DIAGNOSIS: The patient was diagnosed with nephrotic syndrome, acute kidney injury, and MGUS. The pathological diagnosis was IgG4-related tubulointerstitial nephritis, IgG4-related membranous nephropathy. INTERVENTIONS: The patient was treated with intravenous methylprednisolone (40 mg daily), which was changed to oral prednisone 50 mg/d after 2 months. OUTCOMES: After 1 month, the patient exhibited a rapid response only with corticosteroid, and experienced partial remission of serum albumin and proteinuria. LESSONS: This case may suggest a possible relationship between IgG4-RD and MGUS, provide some guidance for investigating the mechanism between them.
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spelling pubmed-75719872020-10-29 Idiopathic membranous nephropathy in a patient diagnosed with IgG4-related disease: A case report Ma, XiaoYing Xu, HaiPing Sun, Jing Yi Gedara, Yuresha Surangani Siyabalagaba Sun, FuYun Medicine (Baltimore) 5200 RATIONALE: Immunoglobulin (Ig) G4-related disease (IgG4-RD) is a newly recognized, systemic disease. Membranous nephropathy is the most common glomerular lesion in IgG4- related kidney disease. However, the lack of relationship with IgG4-related kidney disease and monoclonal gammopathy of undetermined significance (MGUS) warrants investigation of the potential mechanisms. PATIENT CONCERNS: A 62-year-old patient was diagnosed with IgG4-RD, tubulointerstitial nephritis, retroperitoneal fibrosis. After 2 years, she was presented with proteinuria, hypoproteinemia, facial, and bilateral lower limb edema. Furthermore, this patient exhibited deposits of IgG k of monoclonal hyperplasia, and bone marrow plasma cell count was 2.5%. DIAGNOSIS: The patient was diagnosed with nephrotic syndrome, acute kidney injury, and MGUS. The pathological diagnosis was IgG4-related tubulointerstitial nephritis, IgG4-related membranous nephropathy. INTERVENTIONS: The patient was treated with intravenous methylprednisolone (40 mg daily), which was changed to oral prednisone 50 mg/d after 2 months. OUTCOMES: After 1 month, the patient exhibited a rapid response only with corticosteroid, and experienced partial remission of serum albumin and proteinuria. LESSONS: This case may suggest a possible relationship between IgG4-RD and MGUS, provide some guidance for investigating the mechanism between them. Lippincott Williams & Wilkins 2020-10-16 /pmc/articles/PMC7571987/ /pubmed/33080759 http://dx.doi.org/10.1097/MD.0000000000022817 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 5200
Ma, XiaoYing
Xu, HaiPing
Sun, Jing Yi
Gedara, Yuresha Surangani Siyabalagaba
Sun, FuYun
Idiopathic membranous nephropathy in a patient diagnosed with IgG4-related disease: A case report
title Idiopathic membranous nephropathy in a patient diagnosed with IgG4-related disease: A case report
title_full Idiopathic membranous nephropathy in a patient diagnosed with IgG4-related disease: A case report
title_fullStr Idiopathic membranous nephropathy in a patient diagnosed with IgG4-related disease: A case report
title_full_unstemmed Idiopathic membranous nephropathy in a patient diagnosed with IgG4-related disease: A case report
title_short Idiopathic membranous nephropathy in a patient diagnosed with IgG4-related disease: A case report
title_sort idiopathic membranous nephropathy in a patient diagnosed with igg4-related disease: a case report
topic 5200
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571987/
https://www.ncbi.nlm.nih.gov/pubmed/33080759
http://dx.doi.org/10.1097/MD.0000000000022817
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