| A Case of IgA Nephropathy with a Membranoproliferative Glomerulonephritis-like Pattern Presenting as Massive Ascites in a Patient with Alcoholic Liver Disease |
| Sun-Ok Song, M.D.1, Seung-Won Lee, M.D.1, Hee-Woo Lee, M.D.1, Beo-Deul Kang, M.D.1, Shi-Heon Dong, M.D.1, Ja-Sung Choi, M.D.1, Ji-Sun Song, M.D.2, Soo Young Yoon, M.D.1 and Sang Choel Lee, M.D.1 |
Department of Internal Medicine1 and Pathology2
Kwandong University College of Medicine, Goyang, Korea |
| 증례 : 알코올성 간경변 환자에서 다량의 복수로 발현된 막증식성 사구체신염의 양상을 동반한 IgA 신병증 1예 |
| 송선옥1, 이승원1, 이희우1, 강버들1, 동시헌1, 최자성1, 송지선2, 윤수영1, 이상철1 |
| 관동대학교 의과대학 내과학교실1, 병리학교실2 |
|
|
| Abstract |
|
IgA nephropathy can occur commonly in alcoholic liver cirrhosis and is the most common form of secondary IgA nephropathy. Defective clearance of IgA-containing complexes by liver is thought to contribute to the development of IgA nephropathy in alcoholic cirrhosis. Although IgA deposition is found up to 64% in autopsy cases of alcoholic cirrhosis, most patients have mild clinical symptoms, and nephrotic range proteinuria occurs rarely in these patients. We report a case of IgA nephropathy with a membranoproliferative pattern that is detected with unusual massive ascites in a patient with alcoholic liver disease. A 60-year-old male patient was referred to our hospital for evaluation and management of abdominal distension. Abdominal ultrasonographic findings were compatible with diffuse liver cirrhosis with splenomegaly and large amount of ascites. He had nephrotic range proteinuria, azotemia, hyperlipidemia, and hematuria in dipstick. Renal biopsy performed under the impression of acute nephritis revealed mesangial and endocapillary proliferative glomerulonephritis with double contour of capillary loop. Immunofluorescence findings showed mesangial IgA and C3 deposit, compatible with IgA nephropathy. He was treated with high dose steroid, and steroid was tapered during 2 months. Steroid treatment induced complete remission state, and ascites was resolved. |
| Key Words:
IgA nephropathy, Membranoproliferative glomerulonephritis, Ascites, Alcoholic liver disease |
|
PDF Links
Download Citation
