The possible involvement of intestine-derived IgA1: a case of IgA nephropathy associated with Crohn's disease

被引：20

作者：

Terasaka, Tomohiro ^{[1
]}

Uchida, Haruhito A. ^{[1
,2
]}

Umebayashi, Ryoko ^{[1
]}

Tsukamoto, Keiko ^{[1
]}

Tanaka, Keiko ^{[1
]}

Kitagawa, Masashi ^{[1
]}

Sugiyama, Hitoshi ^{[1
,3
]}

Tanioka, Hiroaki ^{[4
]}

Wada, Jun ^{[1
]}

机构：

[1] Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Nephrol Rheumatol Endocrinol & Metab, Kita Ku, 2-5-1 Shikata Cho, Okayama 7008558, Japan

[2] Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Chron Kidney Dis & Cardiovasc Dis, Kita Ku, 2-5-1 Shikata Cho, Okayama 7008558, Japan

[3] Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Human Resource Dev Dialysis Therapy Kidney D, Kita Ku, 2-5-1 Shikata Cho, Okayama 7008558, Japan

[4] Okayama Rosai Hosp, Dept Med Oncol, Minami Ku, 1-10-25 Chikkomidori Machi, Okayama 7028055, Japan

来源：

BMC NEPHROLOGY | 2016年 / 17卷

关键词：

Crohn's disease; IgA nephropathy; IgA(1); IgA(2); Inflammatory bowel disease; INFLAMMATORY-BOWEL-DISEASE; TONSILLECTOMY; COMPLICATIONS;

D O I：

10.1186/s12882-016-0344-1

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Background: A link between IgA nephropathy and Crohn's disease has recently been reported. Other researchers hypothesize that intestine-derived IgA complexes deposit in glomerular mesangial cells, eliciting IgA nephropathy. Intestinal mucosal plasma cells mainly secrete IgA(2). Nevertheless, IgA(1) deposition is strongly implicated as being the primary cause of IgA nephropathy. Case presentation: A 46-year-old Japanese man developed IgA nephropathy 29 years ago, following tonsillectomy. As a result, a normal urinalysis was obtained. The patient previously suffered Crohn's disease followed by urinary occult blood and proteinuria six years ago. Exacerbation of IgA nephropathy was highly suspected. Therefore a renal biopsy was performed. A diagnosis of exacerbation of IgA nephropathy with mesangial cell proliferation and fibrotic cellular crescent was based upon the pathological findings. The patient exhibited a positive clinical course and eventually achieved a remission with immunosuppressive therapy including prednisolone treatment. Immunostaining for the detection of IgA subtypes was performed on both of his kidney and excised ileum. The results revealed IgA(1) and IgA(2) deposition by submucosal cells in intestine. Furthermore, IgA(1) deposition of mesangial areas in the patient's kidney, indicated an association of IgA(1) with the exacerbation of IgA nephropathy. Conclusion: This case represents the possibility that the intestine-derived IgA(1) can be the origin of galactose-deficient IgA which is known to cause IgA nephropathy exacerbation.

引用

页数：4

共 20 条

[1] The Histopathologic Spectrum of Kidney Biopsies in Patients with Inflammatory Bowel Disease [J].