Nephrotic IgA nephropathy associated with disseminated tuberculosis

Matsuzawa, Naoki; Nakabayashi, Kimimasa; Nagasawa, Tasuku; Nakamoto, Yasushi

doi:10.5414/cnp57063

Cited by 17 publications

(12 citation statements)

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“…There have been four case reports of IgAN occurring in patients of pulmonary tuberculosis [3][4][5][6]. Three of these cases presented with nephritic syndrome, and one had microscopic hematuria.…”

Section: Discussionmentioning

confidence: 99%

“…Lupus vulgaris (LV) is the most common form of cutaneous tuberculosis [2] and runs a chronic clinical course. An association between pulmonary tuberculosis and disseminated tuberculosis with IgAN has been previously described [3][4][5][6]; however, this has never been reported to occur in a case of lupus vulgaris. We describe in this communication a case of lupus vulgaris with tubercular lymphadenitis and IgAN, an association never reported before.…”

Section: Introductionmentioning

confidence: 91%

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Lupus vulgaris with tubercular lymphadenitis and IgA nephropathy

et al. 2008

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A 14-year-old girl presented with a 10-year history of a large crusted plaque over the right thigh for 10 years and small reddish plaque over the left upper back for 3 months. On routine evaluation, she was found to have hematuria. Skin biopsy from the lesion was suggestive of skin tuberculosis (lupus vulgaris), and kidney biopsy showed features of IgA nephropathy (IgAN). Fine-needle aspiration from the inguinal lymph node was consistent with granulomatous disease. The patient has been on anti-tubercular treatment, and the hematuria has subsided.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

Lupus vulgaris with tubercular lymphadenitis and IgA nephropathy

et al. 2008

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“…However, it now is apparent that the effects of M. tuberculosis on the kidney can be insidious. Patients may present with glomerular disease, sometimes with advanced renal failure, instead of with symptoms of classic renal TB [4][5][6][7][8]. The diagnosis of TB-associated glomerulonephritis (TB-GN) remains difficult, especially in the early stages, because of its nonspecific manifestation and extreme difficulty in detecting M. tuberculosis.…”

Section: Introductionmentioning

confidence: 99%

Be alert to tuberculosis-mediated glomerulonephritis: a retrospective study

Sun

Qin

Feng

et al. 2011

Eur J Clin Microbiol Infect Dis

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Mycobacterium tuberculosis infection causing glomerulonephritis is a rare disorder. This retrospective study analyzed the clinical characteristics of patients diagnosed with tuberculosis-mediated glomerulonephritis (TB-GN) between 2002 and 2009, as well as the diagnostic tools used. These findings were then compared with those of patients with primary glomerulonephritis (P-GN). The records of all patients were reviewed. The diagnosis of TB-GN was based on renal hematuria and/or proteinuria and cure after antituberculosis therapy alone plus urine culture positive for M. tuberculosis, demonstration of typical tubercle granulomas on renal biopsy specimens, or the detection of M. tuberculosis DNA by polymerase chain reaction (PCR) on renal specimens. Forty-six patients with TB-GN and 49 patients with P-GN were included. Compared with patients in the P-GN group, most (76%) patients with TB-GN had a history of TB. Systemic symptoms were much more frequent in patients with TB-GN than local genitourinary symptoms. Serological testing showed a statistical difference between the two groups. Immunoglobulin A nephropathy was found in the majority (72%) of patients with TB-GN. M. tuberculosis DNA detection was positive in 39 (84.8%) patients, a much higher positive rate of diagnosis than that with urine culture for M. tuberculosis. The manifestation of TB-GN is atypical and nonspecific. It warrants a high index of suspicion when patients with renal hematuria and proteinuria fail to respond to standard treatments for P-GN. Clinicians should pay close attention to the medical history and results of special laboratory tests. M. tuberculosis DNA detection on renal biopsy specimens should be considered in order to confirm the diagnosis of TB-GN.

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“…Some patients present with glomerular disease, sometimes with advanced renal failure, instead of the features of classical renal TB (3,4,6,8,11).…”

Section: Case Reportmentioning

confidence: 99%

Lumbar Tuberculosis Associated with Membranous Nephropathy and Interstitial Nephritis

et al. 2010

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Tuberculosis is a common disease worldwide. However, it now is clear that tuberculosis can affect the kidney more insidiously. We describe a case of lumbar tuberculosis associated with simultaneous membranous nephropathy and interstitial nephritis, in which recovery of renal function occurred after treatment with steroids in addition to antituberculosis agents. CASE REPORTA 50-year-old woman was admitted to the hospital with a 2-week history of hematuria, proteinuria, and renal failure. She had been diagnosed with lumbar tuberculosis (TB) 6 weeks earlier because of mild fever, fatigue, night sweating, weight loss, and low-back pain. Her tuberculin skin test was strongly positive. A colloidal-gold-based serological assay with a Mycobacterium tuberculosis antibody assay kit (Assure TB Rapid Test; MP Biomedicals Asia Pacific Pte. Ltd., Singapore) was used to detect M. tuberculosis antibody. The result was positive. Lumbar X-ray examination showed that the L3-L4 disc space was narrow and destroyed ( Fig. 1). She had been treated with rifampin, isoniazid, ethambutol, and pyrazinamide for 4 weeks before admission. Her temperature normalized, and the lowback pain disappeared. However, 2 weeks before the admission, she developed hematuria and proteinuria. Her serum creatinine, which had been 63 mol/liter 1 month prior to presentation, rose to 183 mol/liter. She reported no abnormal urinary frequency, dysuria, or flank pain. Her remaining medical history, travel history, and family history were unremarkable. Physical examination showed a body temperature of 36.8°C, a regular pulse rate of 85/min, respiratory rate of 18/ min, and blood pressure of 140/85 mm Hg. Laboratory findings included a hemoglobin level of 9.3 g/dl, a platelet count of 320 ϫ 10 9 /liter, and a white cell count of 11.7 ϫ 10 9 /liter. The erythrocyte sedimentation rate was 24 mm/h, and C-reactive protein was 5.45 mg/dl. The blood urea nitrogen was 7.34 mmol/liter, and serum creatinine was 183 mol/liter. Serum complement levels were normal. Urinalysis revealed 2ϩ protein, with 12 to 15 red blood cells and 16 to 20 white blood cells per high-power field (HPF) in the urinary sediment. Daily urinary protein excretion was 2.6 g. Complement 3 (C3) and C4 concentrations were normal. Serology for antinuclear antibody, human immunodeficiency virus, and syphilis was negative, and the patient was not otherwise immunocompromised. Sputum smears for acid-fast stain were negative. Chest X-ray examination was normal. Renal ultrasonography showed normal-size kidneys without any abnormality. PCR analysis using specific primers for M. tuberculosis was performed on earlymorning urine samples for three consecutive days. DNA was extracted from the urine samples with the QIAamp DNA minikit (Qiagen, Hilden, Germany) according to the manufacturer's instructions. The primers targeted to the specific insertion element insertion sequence (IS) IS6110 of M. tuberculosis were synthesized by Takara Bio Inc. (Dalian, China). The amplicon size was 156 bp. The results were positive (Fig...

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Nephrotic IgA nephropathy associated with disseminated tuberculosis

Cited by 17 publications

References 0 publications

Lupus vulgaris with tubercular lymphadenitis and IgA nephropathy

Lupus vulgaris with tubercular lymphadenitis and IgA nephropathy

Be alert to tuberculosis-mediated glomerulonephritis: a retrospective study

Lumbar Tuberculosis Associated with Membranous Nephropathy and Interstitial Nephritis

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