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A Case of Hepatic Glomerulosclerosis with Monoclonal IgA1-κ Deposits.

Yusuke OkabayashiTsuboi NobuoNaoko NakaosaKotaro HaruharaGo KanzakiKentaro KoikeAkihiro ShimizuAkira FukuiHideo OkonogiYoichi MiyazakiTetsuya KawamuraMakoto OguraAkira ShimizuTakashi Yokoo
Published in: Case reports in nephrology (2018)
Glomerular immunoglobulin A (IgA) deposition is a common finding in hepatic glomerulosclerosis; thus, this disease is also called hepatic IgA nephropathy. However, only a small number of patients with hepatic IgA nephropathy have active glomerular lesions, so functional decline is slow in most cases. In this report, we describe a 60-year-old man who developed nephrotic syndrome and progressive renal impairment during follow-up for alcoholic liver cirrhosis. A renal biopsy showed a membranoproliferative glomerulonephritis-like pattern; diffuse double-contours of the glomerular basement membrane and focal active glomerular lesions with moderate-to-severe endocapillary proliferation and fibrocellular crescents. Immunofluorescence findings revealed granular staining for monoclonal IgA1-κ and C3 on the peripheral capillary walls. Laboratory examinations did not reveal any definitive evidence of myeloproliferative disorders. Therefore, this case may represent a previously unrecognized etiology of renal injury in relation to liver cirrhosis that is characterized by monoclonal IgA1-κ deposits and proliferative glomerulonephritis.
Keyphrases
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  • high glucose
  • multiple myeloma
  • multiple sclerosis
  • signaling pathway
  • single cell
  • squamous cell carcinoma
  • high intensity
  • ultrasound guided
  • early onset
  • locally advanced
  • liver injury