Abstract
BackgroundVarious renal manifestations are known to develop in patients with liver disease, including chronic hepatitis and cirrhosis.Case presentationWe evaluated renal disease in two 47-year-old Japanese men with liver cirrhosis and chronic alcoholism for 34 years and 27 years, respectively. Renal biopsy demonstrated massive wire loop-like deposits in the subendothelial space of the glomerular basement membrane and in the mesangium. However, immunofluorescence was only positive for IgA and C3, and electron microscopy did not reveal any organized structures in the electron-dense deposits. IgA nephropathy was diagnosed, although the features were different from primary IgA nephropathy. Both patients had portosystemic shunts associated with liver cirrhosis. Their renal deposits and proteinuria resolved completely after 1 year of steroid therapy.ConclusionAlcohol abuse may have contributed to development of secondary IgA nephropathy in these two patients, probably via their portosystemic shunts.
Highlights
Various renal manifestations are known to develop in patients with liver disease, including chronic hepatitis and cirrhosis.Case presentation: We evaluated renal disease in two 47-year-old Japanese men with liver cirrhosis and chronic alcoholism for 34 years and 27 years, respectively
Alcohol abuse may have contributed to development of secondary IgA nephropathy in these two patients, probably via their portosystemic shunts
Three types of nephropathy have been reported in patients with hepatitis C virus (HCV) infection, including IgG-dominant nephropathies, IgA-dominant nephropathies, and IgMdominant nephropathies (such as type 1 membranoproliferative glomerulonephritis (MPGN), which corresponds to cryoglobulinemic glomerulopathy)
Summary
Various renal manifestations are known to develop in patients with liver disease, including chronic hepatitis and cirrhosis.Case presentation: We evaluated renal disease in two 47-year-old Japanese men with liver cirrhosis and chronic alcoholism for 34 years and 27 years, respectively. IgA nephropathy was diagnosed, the features were different from primary IgA nephropathy Both patients had portosystemic shunts associated with liver cirrhosis. Their renal deposits and proteinuria resolved completely after 1 year of steroid therapy. Various renal manifestations are known to develop in patients with liver disease, including chronic hepatitis and cirrhosis. We report two patients with alcoholic cirrhosis who developed IgA nephropathy featuring massive subendothelial deposits, and we document the response of their renal histology and proteinuria to steroid therapy. His anasarca was treated with furosemide (150 mg daily) and restriction of salt and fluid intake (to 6 g of salt and 1000 mL of water daily) He had a history of drinking 1500 mL of beer daily for 27 years from the age of 20. 24-h urinary protein excretion was 3.9 g and the urine sediment contained numerous erythrocytes per high-power field
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