Coeliac sprue-associated membranoproliferative glomerulonephritis (MPGN).
Publication/Presentation Date
11-1-2009
Abstract
Coeliac sprue (CS) may occur in association with immune complex-mediated diseases, including IgA nephropathy, dermatitis herpetiformis and thyroiditis. An association of CS with membranoproliferative glomerulonephritis (MPGN) type 1 is rare, with only two prior cases reported. Here we describe a 45-year-old man with no prior medical history who presented initially with microhaematuria, subnephrotic proteinuria and hypocomplementaemia. A renal biopsy revealed MPGN type 1 with negative serologic workup for secondary causes. The patient was treated conservatively with angiotensin-converting enzyme inhibitors. Several months later, he developed daily non-bloody diarrhoea and was found to have worsening hypoalbuminaemia, hypophosphataemia and severe iron deficiency anaemia. A diagnosis of CS was established based on elevated tTGA (IgA anti-tissue transglutaminase) antibody and positive IgA antiendomysial antibody titres. Proteinuria resolved completely following the initiation of a gluten-free diet, without the use of immunosuppressive therapy and despite tapering of angiotensin-converting enzyme inhibitor. This case illustrates that CS-associated MPGN may precede overt clinical evidence of coeliac disease and may respond to gluten-free diet, without resort to immunosuppressive therapy.
Volume
24
Issue
11
First Page
3545
Last Page
3548
ISSN
1460-2385
Published In/Presented At
Jhaveri, K. D., D'Agati, V. D., Pursell, R., & Serur, D. (2009). Coeliac sprue-associated membranoproliferative glomerulonephritis (MPGN). Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 24(11), 3545–3548. https://doi.org/10.1093/ndt/gfp353
Disciplines
Medicine and Health Sciences
PubMedID
19625370
Department(s)
Department of Medicine
Document Type
Article