Rapidly Progressive Glomerulonephritis Secondary to IgA Nephropathy in a Patient with Systemic Lupus Erythematosus

Lupus nephritis is a common manifestation of systemic lupus erythematosus (SLE). IgA nephropathy is a common type of primary glomerulonephritis. Renal manifestations in SLE patients are often due to lupus nephritis; however, renal diseases unrelated to lupus nephritis are rarely reported. While cres...

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Published inCase Reports in Nephrology Vol. 2019; no. 2019; pp. 1 - 7
Main Authors Truong, Luan D., Redfearn, Warren E., Rojas, Stephanie C. Fuentes, Karam, Lily Anne Romero, Patel, Amol M., Gonzalez, Juan M.
Format Journal Article
LanguageEnglish
Published Cairo, Egypt Hindawi Publishing Corporation 2019
Hindawi
Hindawi Limited
Subjects
Biopsy
Case Report
Case reports
Chronic kidney failure
Development and progression
Diabetes
Glomerulonephritis
Hypertension
Immunoglobulin A
Kidney diseases
Lupus
Medical prognosis
Methenamine
Microscopy
Nephrology
Patients
Systemic lupus erythematosus
Type 2 diabetes
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Summary:Lupus nephritis is a common manifestation of systemic lupus erythematosus (SLE). IgA nephropathy is a common type of primary glomerulonephritis. Renal manifestations in SLE patients are often due to lupus nephritis; however, renal diseases unrelated to lupus nephritis are rarely reported. While crescentic IgA nephropathy with rapid clinical progression is rare, its development in patients with SLE in the absence of lupus nephritis is even more unusual. A 74-year-old woman with a history of SLE without known renal involvement, chronic kidney disease stage IIIa, congestive heart failure, hypertension, and type 2 diabetes mellitus presented with acute kidney injury. Her creatinine continued to rise rapidly. Renal biopsy revealed mesangial proliferative glomerulonephritis with crescent formation. Immunofluorescent staining showed IgA and C3 mesangial deposition and absence of C4 and C1q, consistent with IgA nephropathy. She received a course of methylprednisolone and plasmapheresis. Unfortunately, her renal function continued to deteriorate, and she was started on hemodialysis which was continued after hospital discharge. This case illustrates crescentic IgA nephropathy without lupus nephritis as the cause of acute kidney injury in a patient with SLE. It highlights the observation that renal diseases other than lupus nephritis can develop in SLE patients.
Bibliography:Academic Editor: Yoshihide Fujigaki
ISSN:2090-6641
2090-665X
DOI:10.1155/2019/8354823