دورية أكاديمية
A report of three cases of patients with tubulointerstitial nephritis with IgM-positive plasma cells, treatment, and serum-IgM as a sensitive marker for relapse
| العنوان: | A report of three cases of patients with tubulointerstitial nephritis with IgM-positive plasma cells, treatment, and serum-IgM as a sensitive marker for relapse |
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| المؤلفون: | Ryota Akagi, Akira Ishii, Keiichi Kaneko, Naoya Kondo, Hideki Yokoi, Takeshi Matsubara, Sachiko Minamiguchi, Yoshihiko Kanno, Motoko Yanagita |
| المصدر: | BMC Nephrology, Vol 24, Iss 1, Pp 1-7 (2023) |
| بيانات النشر: | BMC |
| سنة النشر: | 2023 |
| المجموعة: | Directory of Open Access Journals: DOAJ Articles |
| مصطلحات موضوعية: | Tubulointerstitial nephritis with IgM-positive plasma cells, Relapse, Serum IgM, Distal renal tubular acidosis (d-RTA), Fanconi syndrome, Sjögren syndrome, Diseases of the genitourinary system. Urology, RC870-923 |
| الوصف: | Background Tubulointerstitial nephritis with IgM-positive plasma cells (IgMPC-TIN) is a newer disease about which there are many unclear points. Glucocorticoid therapy is effective in many cases of IgMPC-TIN; however, relapse during glucocorticoid tapering has been reported. Relapse and its treatment are poorly defined. Case Presentation Case 1 was a 61-year-old man with renal dysfunction and proteinuria. Tubulointerstitial nephritis and IgM-positive plasma cells were observed in a renal biopsy. He was diagnosed with IgMPC-TIN accompanied by Fanconi syndrome and distal renal tubular acidosis (d-RTA). Prednisolone (PSL; 30 mg daily, 0.45 mg/kg/day) treatment was highly effective, and PSL was gradually tapered and discontinued after 1 year. However, 1 month after PSL discontinuation, therapeutic markers were elevated. Therefore, PSL (10 mg daily, 0.15 mg/kg/day) was administered, and the markers indicated improvement. Case 2 was a 43-year-old woman referred for renal dysfunction and proteinuria. Laboratory data revealed that she had primary biliary cholangitis (PBC), d-RTA, and Fanconi syndrome. A renal biopsy showed accumulation of IgM-positive plasma cells in the tubulointerstitium without any glomerular changes. A diagnosis of IgMPC-TIN was made and the patient was started on PSL (35 mg daily, 0.6 mg/kg/day). Therapeutic markers decreased immediately and PSL was discontinued after 1 year. Three months later, the proteinuria and Fanconi syndrome worsened. PSL treatment was restarted (20 mg daily, 0.35 mg/kg/day) and markers indicated improvement. Case 3 was a 45-year-old woman with renal dysfunction and proteinuria. Tubulointerstitial nephritis and IgM-positive plasma cells were observed in a renal biopsy. The patient had PBC, Sjögren syndrome, d-RTA, and Fanconi syndrome, and the diagnosis of IgMPC-TIN was made. The patient was started on PSL (30 mg daily, 0.4 mg/kg/day) and disease markers decreased immediately. However, when PSL was tapered to 15 mg daily (0.2 mg/kg/day), the patient’s serum IgM ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 1471-2369 |
| العلاقة: | https://doi.org/10.1186/s12882-023-03253-8Test; https://doaj.org/toc/1471-2369Test; https://doaj.org/article/49d6c564e6e64ce28badca183768bf82Test |
| DOI: | 10.1186/s12882-023-03253-8 |
| الإتاحة: | https://doi.org/10.1186/s12882-023-03253-8Test https://doaj.org/article/49d6c564e6e64ce28badca183768bf82Test |
| رقم الانضمام: | edsbas.EA107E6 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 14712369 |
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| DOI: | 10.1186/s12882-023-03253-8 |