MPO-ANCA-positive IgA nephropathy successfully treated with tonsillectomy

被引：8

作者：

Ogawa N. ^{[1
]}

Yano S. ^{[1
]}

Yamane Y. ^{[1
]}

Nishiki M. ^{[1
]}

Yamaguchi T. ^{[1
]}

Tsukamoto T. ^{[2
]}

Muso E. ^{[2
]}

Sugimoto T. ^{[1
]}

机构：

[1] First Department of Internal Medicine, Shimane University, Faculty of Medicine, Izumo, Shimane 693-8501

[2] Kitano Hospital, Osaka

来源：

Clinical and Experimental Nephrology | 2007年 / 11卷 / 4期

关键词：

Antineutrophil cytoplasmic antibody; IgA nephropathy; Tonsillectomy;

D O I：

10.1007/s10157-007-0506-3

中图分类号：

学科分类号：

摘要：

A 20-year-old Japanese woman was admitted to a hospital because of gross hematuria. She was diagnosed with IgA nephropathy with a poor prognosis, based on the formation of many crescents in the glomerulus and monocyte infiltration in the interstitium in a renal biopsy specimen in February 2003. Myeloperoxidase (MPO)-antineutrophil cytoplasmic antibody (ANCA) was not identified at that time. After treatment with high-dose steroid pulse therapy and heparin/warfarin, her urinary protein improved, to 0.5 g/day. However, 1 year after the steroid pulse therapy, urinary protein was increased to 1.2 g/day, associated with repeated episodes of tonsillitis. A second renal biopsy was performed, and showed an improving tendency, compared to the findings of the previous one, although some crescent formation and adhesions of Bowman's capsule remained. Interestingly, MPO-ANCA was positive in the serological examination done at this time. One month and a half after the second renal biopsy, she had a tonsillectomy, followed by a regimen of 5 mg oral prednisolone daily, in order to prevent the progression of IgA nephropathy. After the tonsillectomy, her urinary protein level was markedly improved, at 0.14 g/day. Her creatinine clearance was ameliorated, at 102 ml/min, and in addition, MPO-ANCA had disappeared. This case suggests that an inflammation such as tonsillitis may be associated not only with the activity of IgA nephropathy but also with the production of MPO-ANCA. © 2007 Japanese Society of Nephrology.

引用

页码：326 / 331

页数：5

共 25 条

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