Rapidly progressive cryoglobulinemic glomerulonephritis.

Abstract:

:The clinical course of cryoglobulinemic glomerulonephritis (CGGN) is usually slowly progressive, and only a minority of these patients progress to end-stage renal failure. This report describes an atypical case of a patient with CGGN who demonstrated a rapidly progressive and irreversible renal deterioration. After presenting with symptoms of an upper respiratory infection, the patient exhibited oliguric acute renal failure, which was followed by systemic efflorescence accompanied by a fever. The laboratory analyses of his serum revealed the patient to be cryoglobulin-positive with markedly decreased serum C4 levels and an increased anti-streptolysin O titer. A serological test for the hepatitis C virus was negative. A renal biopsy showed that the patient had diffuse endocapillary and extracapillary proliferation together with marked endoluminal thrombi and subendothelial deposits in glomeruli. An electron microscopic examination demonstrated the presence of electron-dense subendothelial, subepithelial and huge intraluminal deposits with a specific annular and cylindrical structure. These features were consistent with active and severe CGGN. Despite aggressive treatment with corticosteroid pulses and a plasma exchange, a second renal biopsy demonstrated further advanced renal injury and revealed no signs of recovery.

journal_name

Clin Exp Nephrol

authors

Tsuboi N,Ichinose M,Kawamura T,Joh K,Utsunomiya Y,Hosoya T

doi

10.1007/s10157-010-0301-4

subject

Has Abstract

pub_date

2010-10-01 00:00:00

pages

492-5

issue

5

eissn

1342-1751

issn

1437-7799

journal_volume

14

pub_type

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