IgG4-related tubulointerstitial nephritis and hepatic inflammatory pseudotumor without hypocomplementemia

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概要

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• Immunoglobulin G4 (IgG4)-related tubulointerstitial nephritis (TIN) is often accompanied by autoimmune pancreatitis (AIP) or chronic sclerosing dacryoadenitis and sialoadenitis. However, IgG4-related TIN without AIP or lacrimal and/or salivary gland lesions has not been well recognized. Here, we report a case of IgG4-related TIN associated with hepatic inflammatory pseudotumor without AIP or lacrimal and/or salivary gland lesions. A 58-year-old Japanese man with epigastralgia underwent contrast-enhanced computed tomography (CT), which revealed multiple low-density lesions in both kidneys and a low density hepatic mass. Laboratory tests showed an extremely high level of serum IgG4. Percutaneous renal and hepatic biopsies showed diffuse infiltration of lymphocytes and IgG4-positive plasma cells with fibrosis in both tissues. Two months after administration of oral prednisolone, both lesions decreased in size on follow-up CT, and the serum cre-atinine level also improved. No recurrence has been detected for two years with a maintenance dose of pred-nisolone. © 2011 The Japanese Society of Internal Medicine.

著者

• NAKAJIMA Kenichi

  Department of Biotracer Medicine, Kanazawa University Graduate School of Medical Sciences

• Inoue Dai

  Department Of Applied Physics Waseda University

• Kakuchi Yasushi

  Division Of Rheumatology Department Of Internal Medicine Graduate School Of Medical Science Kanazawa

• Yamada Kazunori

  Division Of Cardiology Shizuoka City Hospital

• Kawano Mitsuhiro

  Division Of Rheumatology Department Of Internal Medicine Graduate School Of Medical Science Kanazawa

• Umehara Hisanori

  Hematology And Immunology Kanazawa Medical University

• Yamagishi Masakazu

  Division Of Cardiology Department Of Internal Medicine Kanazawa University Graduate School Of Medici

• Matsumura Masami

  Research Center For Medical Education Kanazawa University Graduate School Of Medicine

• Mizushima Ichiro

  Division Of Nephrology And Rheumatology Ishikawa Prefectural Central Hospital

• KIM Fae

  Division of Rheumatology, Ishikawa Prefecturel Central Hospital

• FUJII Hiroshi

  Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University

• Kakuchi Yasushi

  Division of Rheumatology, Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Japan

• Nakajima Kenichi

  Department of Nuclear Medicine, Kanazawa University Hospital, Japan

• Narumi Kenta

  Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Japan

• Yamagishi Masakazu

  Division of Cardiology, Department of Internal Medicine, Graduate School of Medicine, Kanazawa University, Japan

• Matsumura Masami

  Research Center for Medical Education, Graduate School of Medicine, Kanazawa University, Japan

• Mizushima Ichiro

  Division of Rheumatology, Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Japan

• Kim Fae

  Division of Rheumatology, Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Japan

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