Immunoglobulin A Nephropathy and Ulcerative Colitis

Abstract

The immune response has largely been implicated in the pathogenesis of inflammatory bowel disease (ulcerative colitis and Crohn’s disease) and immunoglobulin A nephropathy. We present a 26-year-old woman with a long past history of asymptomatic macroscopic hematuria who later developed several episodes of bloody stools and abdominal pain. A colonic biopsy disclosed ulcerative colitis and a renal biopsy was consistent with immunoglobulin A nephropathy. Immunoglobulin A nephropathy is the most common glomerulonephritis, being end-stage renal disease a rare but the most serious complication. It can be primary or secondary, but the association between both entities is unusually observed. We discuss the possible immunologic mechanisms involved and believe the initial immunologic derangement originates in the bone marrow. We suggest both conditions must be considered when either a patient with ulcerative colitis and micro- or macrohematuria or with renal involvement and a past history of diarrhea or abdominal pain presents.

The Histopathologic Spectrum of Kidney Biopsies in Patients with Inflammatory Bowel Disease

“…They described both clinical and pathologic remission of kidney disease concomitant with the treatment of symptoms of intestinal disease. Nineteen subsequent case reports in the literature have described IgAN in IBD (9,22,(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). A majority of these patients had IgAN during onset or exacerbation of IBD, as well as clinical remission of kidney disease in conjunction with successful treatment of bowel inflammation.…”

Concomitant Aseptic Subcutaneous Abscess and Immunoglobulin M Nephropathy—Rare Extraintestinal Manifestations in Ulcerative Colitis

“…Renal and genitourinary tract manifestations are quite rare in IBD, especially glomerulonephritis. Some renal involvements reported in IBD are aminosalicylate-related interstitial nephritis and IgA nephropathy (10)(11)(12)(13). In literature review, only one case of mesangial IgMN associated with UC has been de- scribed (14).…”

Immunoglobulin A nephropathy complicating ulcerative colitis

“…In a literature review, we found seven reports of IgAN in Crohn's disease [8][9][10][11][12][13][14][15], five reports in ulcerative colitis [16][17][18][19][20], and one report of IgAN with circulating immune complexes containing IgA in inflammatory bowel disease [21]. These reports described a total of 15 patients.…”