We report a rare case of primary glomerular disease with IgA nephropathy in a 43-year old man. 7-years ago, he was diagnosed with minimal change nephrotic syndrome. After treatment with steroid for 1-year, azotemia and proteinuria were improved. But, ...
We report a rare case of primary glomerular disease with IgA nephropathy in a 43-year old man. 7-years ago, he was diagnosed with minimal change nephrotic syndrome. After treatment with steroid for 1-year, azotemia and proteinuria were improved. But, nephrotic range proteinuria was relapsed within 1 week after cessation of steroid. Renal biopsy revealed focal segmental glomerulosclerosis, and achived a complete remission with the use of steroids and cyclophosphamide. Then, he was followed up with normal renal function for 4-years. On admission, the patient showed generalized edema and marked proteinuria. In 3rd renal biopsy, mesangial proliferative glomerulonephritis with diffuse global sclerosis was observed. Electron microscopy showed electron-dense deposit on the mesangium with slight mesangial proliferation, and immunofluoroscence microscopy showed granular deposits of IgA and IgM. These features were consistent with IgA nephropathy, different from results of previous biopsies. The pathogenesis of IgA nephropathy occurred with primary FSGS is not clear, as well as treatment. Now, proteinuria is improving, steroid and cyclophosphamide are probably useful for the disease.