Interstitial Nephritis Associated with Glomerulonephritis in a Patient with Hashimoto's Disease and Idiopathic Portal Hypertension

• Published in: Internal Medicine Vol. 31; no. 5; pp. 641 - 648
• Main Authors: SASAKI, Hidetsugu, JOH, Kensuke, OHTSUKA, Isako, OHTA, Hideki, OHHASHI, Tsutomu, HOASHI, Seiji, TAKAHASHI, Takamune, TOKUDA, Tadaaki, KOYAMA, Katsuichi, ISOGAI, Yukihide
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 1992
• Subjects: Female; Glomerulonephritis - complications; Glomerulonephritis - immunology; Glomerulonephritis - pathology; hepatic glomerulosclerosis; Humans; hypergammaglobulinemia; Hypertension, Portal - complications; Hypertension, Portal - pathology; IgA deposits; Immunoglobulin A - metabolism; Kidney Glomerulus - immunology; Microscopy, Electron; Middle Aged; Nephritis, Interstitial - complications; Nephritis, Interstitial - pathology; nephrotic syndrome; osmiophilic body; Thyroiditis, Autoimmune - complications
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.31.641

A middle-aged woman with hypothyroidism, idiopathic portal hypertension and nephrotic syndrome is presented. This unusual clinical appearance could not be explained as SLE by serological examinations. Pathohistological examinations showed "Banti's liver", Hashimoto's thyroiditis and diffuse proliferative glomerulonephritis with severe tubulo-interstitial nephritis. Immunohistochemical studies revealed IgA deposits in glomeruli. Electron microscopic study disclosed peculiar lucent areas of rare faction with osmiophilic particles in tubular basement membranes. This tubulointerstitial nephritis was considered to be related to the immunological mechanism involving thyroid gland, liver and kidney disorders. This case thus had a clinically rare combination of these three. (Internal Medicine 31 : 641-648, 1992)