Korean Journal of Nephrology 2010;29(1):125-130.
Development of IgA Nephropathy after Clinical Remission of Dense Deposit Disease
Min Ju Kim, M.D.1 Beom Jin Lim, M.D., Ph.D.1 Jae Il Shin, M.D., Ph.D.2 Jae Seung Lee, M.D., Ph.D.2, Yoon Hee Lee, M.D.3, Kensuke Joh,4 Pyung Kil Kim, M.D., Ph.D.5 and Hyeon Joo Jeong, M.D., Ph.D.1
The Institute of Kidney Disease1
Department of Pathology Yonsei University College of Medicine, Seoul, Korea The Institute of Kidney Disease2
Department of Pediatrics Yonsei University College of Medicine, Seoul, Korea Department of Pathology3
Kangnam CHA Hospital Pochon CHA University College of Medicine, Seongnam, Korea Division of Renal Pathology4
Clinical Research Center Chiba-East National Hospital, Chiba, Japan Department of Pediatrics5
Kwandong University College of Medicine, Koyang, Korea
증례 : Development of IgA Nephropathy after Clinical Remission of Dense Deposit Disease
Min Ju Kim, M.D.1 Beom Jin Lim, M.D., Ph.D.1 Jae Il Shin, M.D., Ph.D.2 Jae Seung Lee, M.D., Ph.D.2, Yoon Hee Lee, M.D.3, Kensuke Joh,4 Pyung Kil Kim, M.D., Ph.D.5 and Hyeon Joo Jeong, M.D., Ph.D.1
The Institute of Kidney Disease1, Department of Pathology Yonsei University College of Medicine, Seoul, Korea The Institute of Kidney Disease2, Department of Pediatrics Yonsei University College of Medicine, Seoul, Korea Department of Pathology3, Kangnam
Abstract
Dense deposit disease (DDD) is a rare primary glomerulonephritis characterized by continuous bandlike intramembranous dense deposits detectable on electron microscopy. We describe a case of DDD with sequential mesangial proliferative glomerulonephritis, membranoproliferative glomerulonephritis, minor glomerular alterations, and a second round of mesangial proliferative glomerulonephritis during a 13-year period. Electron dense deposits were typical of DDD in the first and second biopsies taken one year apart. However, deposits dissolved and the glomerular cellularity and basement membrane normalized with clinical remission, which was achieved by a course of immunosuppressive therapy lasting seven years. The fourth biopsy was performed due to recurrence of microscopic hematuria and showed predominant mesangial IgA deposits without glomerular capillary alteration, which was interpreted as development of IgA nephropathy after remission of DDD or coexistence with nearly healed DDD in this patient.
Key Words: Hypocomplementemic glomerulonephritis, Dense deposit disease, IgA nephropathy


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