A case of rapidly progressive IgA nephropathy in a patient with exacerbation of Crohn’s disease

• Main Authors: Choi Ji-Young, Yu Chung, Jung Hee-Yeon, Jung Min, Kim Yong-Jin, Cho Jang-Hee, Kim Chan-Duck, Kim Yong-Lim, Park Sun-Hee
• Format: Article
• Language: English
• Published: BMC 2012-08-01
• Series: BMC Nephrology
• Subjects: Rapidly progressive IgA nephropathy; Crohn’s disease
• Online Access: http://www.biomedcentral.com/1471-2369/13/84

<p>Abstract</p> <p>Background</p> <p>IgA nephropathy has been reported as a renal involvement in Crohn’s disease. Crescentic IgA nephropathy, which accounts for fewer than 5% of cases of IgA nephropathy, has a poorer prognosis than other forms of crescentic glomerulonephritis. We recently experienced a case of rapidly progressive IgA nephropathy concurrent with exacerbation of Crohn’s disease.</p> <p>Case presentation</p> <p>An 18-year-old male diagnosed with Crohn’s disease underwent a hemicolectomy 2 years prior previously. He had maintained a state of Crohn’s disease remission with 5-aminosalicylic acid treatment. Four months prior to referral to the nephrology clinic, he experienced non-bloody diarrhea. He simultaneously developed proteinuria and microscopic hematuria with deterioration of renal function. Based on renal biopsy findings, the patient was diagnosed with crescentic IgA nephropathy. Immunostaining for interleukin-17 in renal tissue and previous exacerbated colonic ulcers was positive. Steroid pulse therapy was administered, followed by high-dose glucocorticoid and oral cyclophosphamide therapy. The patient’s renal function recovered and his gastrointestinal symptoms were alleviated.</p> <p>Conclusions</p> <p>We report a case of crescentic IgA nephropathy presenting with exacerbation of Crohn’s disease, and present a review of the literature focusing on the pathophysiologic relationship between these two conditions.</p>