IgG4-related tubulointerstitial nephritis
- Resource Type
- Authors
- Deepa Jacob; Tasnim Momoniat; Neelaveni Duhli; Tom Jorna
- Source
- BMJ case reports. 14(11)
- Subject
- Male
Pathology
medicine.medical_specialty
Plasma Cells
Arthritis
Renal function
Azathioprine
Kidney
Fibrosis
medicine
Humans
Aged
medicine.diagnostic_test
business.industry
Acute kidney injury
General Medicine
Eosinophil
medicine.disease
medicine.anatomical_structure
Immunoglobulin G
Nephritis, Interstitial
Renal biopsy
Immunoglobulin G4-Related Disease
business
medicine.drug
Kidney disease
- Language
- ISSN
- 1757-790X
A 67-year-old man was referred to the renal team following an episode of acute kidney injury on a background of chronic kidney disease. He had a 9-year history of steroid-sensitive arthritis, epigastric pain and isolated submandibular gland enlargement. He was noted to have a raised eosinophil count, total serum protein and total immunoglobulin G4 (IgG4) level as well as a serum hypocomplementaemia. A renal biopsy showed a tubulointerstitial nephritis with lymphoplasmacytic infiltrates, fibrosis and IgG4-positive plasma cells on immunohistochemistry. A diagnosis of IgG4-related disease was made based on clinical presentation and pathology. Renal function improved with glucocorticoids and the patient was successfully transitioned to azathioprine as a steroid-sparing agent.