A case report and literature review of IgA nephropathy presenting as nephrotic syndrome in polycythemia vera.
R RajasekarR NandakumarSaurav P SinghviGerry George MathewVaradharajan JayaprakashK MythiliPublished in: CEN case reports (2024)
A 66-year-old non-smoker presented with a 2-week history of new-onset pedal oedema and gross haematuria. On evaluation, he was found to be hypertensive and oedematous with a haemoglobin of 19.1 g/dl, platelet count of 546,000/mm 3 , and creatinine of 2.6 mg/dl. Urine examination revealed abundant RBCs with 3+ albumin on three separate occasions. His 24-h urine protein level was 3830 mg/day, with a serum cholesterol level of 303 mg/dl. Secondary erythrocytosis and thrombocytosis tests were negative. Bone marrow examination revealed hypercellularity, erythroid hyperplasia, tight clusters of large megakaryocytes, and megakaryocytic hyperplasia suggestive of polycythemia vera. PCR analysis revealed a JAK2V617 F (exon 14) mutation. In view of nephrotic syndrome, azotemia, and microscopic haematuria, a renal biopsy was performed, which revealed features of IgA nephropathy with advanced interstitial fibrosis and tubular atrophy. He was started on angiotensin receptor blockers with hydroxy urea as a part of treatment. This case report highlights the association of glomerular disease with polycythaemia vera and the need of prompt renal biopsy for diagnosis and management.
Keyphrases
- single cell
- bone marrow
- case report
- angiotensin converting enzyme
- blood pressure
- ultrasound guided
- mesenchymal stem cells
- blood brain barrier
- randomized controlled trial
- angiotensin ii
- peripheral blood
- amino acid
- small molecule
- protein protein
- study protocol
- combination therapy
- uric acid
- children with cerebral palsy
- low density lipoprotein