A case of systemic sarcoidosis with mesangial proliferative glomerulonephritis showing predominant deposition of IgG in the mesangial region.


Journal

CEN case reports
ISSN: 2192-4449
Titre abrégé: CEN Case Rep
Pays: Japan
ID NLM: 101636244

Informations de publication

Date de publication:
05 2022
Historique:
received: 06 10 2021
accepted: 01 11 2021
pubmed: 10 11 2021
medline: 6 5 2022
entrez: 9 11 2021
Statut: ppublish

Résumé

A 37-year-old African-British man was referred to our hospital for detailed examination because of persistent fever, swelling and pain in both ankle joints, and blurred vision for two months. Inguinal lymph node biopsy showed a large number of epithelioid granulomas without necrosis. Granulomatous anterior uveitis, nephropathy, high serum angiotensin-converting enzyme activity, and high serum-soluble interleukin-2 receptor were observed, and the diagnosis of systemic sarcoidosis was made. His serum creatinine was 1.4 mg/dL and hematuria, leukocyturia, and urine protein were also seen. The renal biopsy finding was mesangial proliferative glomerulonephritis, with no findings of granuloma formation or tubular interstitial nephritis. Immunofluorescence staining showed deposition of IgG, C3, and C1q in the mesangial region. IgG3 was dominant in subclass staining. There was no monoclonality on kappa and lambda staining. Electron microscopy showed predominant deposition in the mesangial region with some subepithelial and endothelial deposition. His hematuria and leukocyturia disappeared with steroid therapy, suggesting sarcoidosis-related nephropathy. A case of systemic sarcoidosis with mesangial proliferative glomerulonephritis showing predominant deposition of IgG in the mesangial region is presented. No cases of such histological findings have been reported so far, and it is necessary to analyze further cases to clarify the pathogenic significance of the renal biopsy findings observed in this case.

Identifiants

pubmed: 34751926
doi: 10.1007/s13730-021-00660-4
pii: 10.1007/s13730-021-00660-4
pmc: PMC9061903
doi:

Substances chimiques

Immunoglobulin G 0

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

231-236

Informations de copyright

© 2021. Japanese Society of Nephrology.

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Auteurs

Kimio Watanabe (K)

Division of Kidney Center, St Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan. spyh63x9@gmail.com.

Sho Fukui (S)

Immuno-Rheumatology Center, St Luke's International Hospital, Tokyo, Japan.

Kasumi Konishi (K)

Division of Kidney Center, St Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.

Yugo Ito (Y)

Division of Kidney Center, St Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.

Takuya Fujimaru (T)

Division of Kidney Center, St Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.

Masahiko Nagahama (M)

Division of Kidney Center, St Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.

Fumika Taki (F)

Division of Kidney Center, St Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.

Koyu Suzuki (K)

Department of Pathology, St Luke's International Hospital, Tokyo, Japan.

Masaaki Nakayama (M)

Division of Kidney Center, St Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.

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Classifications MeSH