| Acute Renal Failure in Coexisting IgA Nephropathy and Acute Interstitial Nephritis: Complete Recovery after Hemodialysis and Steroid Therapy |
| Ju-Hyun Lee, M.D.1, Ji-Won Ryu, M.D.1, Hyun-Seok Hong, M.D.1, Joo-Hark Yi, M.D.1, Sang-Woong Han, M.D.1, Moon-Hyang Park, M.D.2 and Ho-Jung Kim, M.D.1 |
Department of Internal Medicine1
Hanyang University Guri Hospital, Guri, Korea, Department of Pathology2
Hanyang University College of Medicine, Seoul, Korea |
| 증례 : IgA 신증에서 병발된 급성 간질성 신염에 의한 급성 신부전을 혈액투석과 스테로이드 충격 요법으로 치료한 1예 |
| 이주현1, 류지원1, 홍현석1, 이주학1, 한상웅1, 박문향2, 김호중1 |
| 한양대학교 구리병원 내과1, 한양대학교 의과대학 병리학교실2 |
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| Abstract |
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Acute renal failure in Immunoglobulin A nephropathy (IgAN), a rare event, is associated with acute tubular necrosis mainly induced by intratubular erythrocytic cast and crescentic glomerulonephropathy (rapidly progressive glomerulonephritis) and the severity paralleled to the degree of glomerular damage. The changes are regarded as those of secondary atrophic response to the glomerular lesions. In that case, renal progression correlates more closely with the severity of tubulointerstitial lesions than with the degree of glomerular lesions in IgAN. Rarely, acute tubulointerstitial nephritis (TIN) could develop independently in primary glomerulonephritis. In this case, the severity of tubulointerstitial lesion was out of proportion with damage of glomerular lesion. To the best of our knowledge, we report the first case of a patient with independently developed severe acute TIN complicating IgAN in Korea. A 38- year-old man was admitted with recurrent hematuria. Proteinuria (<1 g) and severe renal failure were noted and hemodialysis was started. In renal biopsy, IgAN associated with acute TIN was diagnosed. He showed good response to steroid therapy and maintained normal renal function after discontinuation of medication. |
| Key Words:
IgA nephropathy, Interstitial nephritis, Acute renal failure, Hematuria, Proteinuria |
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