Association of acute tubular necrosis with gross hematuria in cirrhosis-related immunoglobulin A nephropathy

Abstract Immunoglobulin A (IgA) nephropathy associated with cirrhosis is the most common form of secondary IgA nephropathy (IgAN). Cirrhosis-related IgAN is usually clinically silent with a rare occurrence of gross hematuria, unlike in cases of idiopathic IgAN. Especially, acute tubular necrosis (AT...

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Published in:Kidney research and clinical practice 2013, 32(1), , pp.43-46
Main Authors: Soo Han, Jang, Dug Lim, So, Hyeok Choi, Won, Chul Hong, Sung, Hee Park, Jung, Park, Eugene, Jin Hong, Mi, Lee, Cho I, Hwan Park, Jung, Ho Lee, Jong, Oh Song, Jong, Il Jo, Young
Format: Article
Language:English
Subjects:
Case Report
Cirrhosis
Hematuria
Lamivudine
Nephrology
Renal failure
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Summary:Abstract Immunoglobulin A (IgA) nephropathy associated with cirrhosis is the most common form of secondary IgA nephropathy (IgAN). Cirrhosis-related IgAN is usually clinically silent with a rare occurrence of gross hematuria, unlike in cases of idiopathic IgAN. Especially, acute tubular necrosis (ATN) associated with gross hematuria is very rare in cirrhosis-related IgAN, although acute renal failure is a frequently reported complication in advanced cirrhosis. Herein, we report an unusual case of ATN requiring renal replacement therapy, associated with gross hematuria in a patient with nonalcoholic, hepatitis B virus-associated cirrhosis. Results of a histopathological analysis revealed obstruction of the lumen of renal tubules by red blood cell casts, a marked tubular necrosis, and IgA deposition in the mesangium. The patient's renal function and gross hematuria were clearly improved after lamivudine treatment.
ISSN:2211-9132
2211-9140
DOI:10.1016/j.krcp.2012.12.003