The possible involvement of intestine-derived IgA1: A case of IgA nephropathy associated with Crohn's disease

Tomohiro Terasaka, Haruhito Adam Uchida, Ryoko Umebayashi, Keiko Tsukamoto, Keiko Tanaka, Masashi Kitagawa, Hitoshi Sugiyama, Hiroaki Tanioka, Jun Wada

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: A link between IgA nephropathy and Crohn's disease has recently been reported. Other researchers hypothesize that intestine-derived IgA complexes deposit in glomerular mesangial cells, eliciting IgA nephropathy. Intestinal mucosal plasma cells mainly secrete IgA2. Nevertheless, IgA1 deposition is strongly implicated as being the primary cause of IgA nephropathy. Case presentation: A 46-year-old Japanese man developed IgA nephropathy 29 years ago, following tonsillectomy. As a result, a normal urinalysis was obtained. The patient previously suffered Crohn's disease followed by urinary occult blood and proteinuria six years ago. Exacerbation of IgA nephropathy was highly suspected. Therefore a renal biopsy was performed. A diagnosis of exacerbation of IgA nephropathy with mesangial cell proliferation and fibrotic cellular crescent was based upon the pathological findings. The patient exhibited a positive clinical course and eventually achieved a remission with immunosuppressive therapy including prednisolone treatment. Immunostaining for the detection of IgA subtypes was performed on both of his kidney and excised ileum. The results revealed IgA1 and IgA2 deposition by submucosal cells in intestine. Furthermore, IgA1 deposition of mesangial areas in the patient's kidney, indicated an association of IgA1 with the exacerbation of IgA nephropathy. Conclusion: This case represents the possibility that the intestine-derived IgA1 can be the origin of galactose-deficient IgA which is known to cause IgA nephropathy exacerbation.

Original languageEnglish
Article number122
JournalBMC Nephrology
Volume17
Issue number1
DOIs
Publication statusPublished - Sep 5 2016

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Crohn Disease
Immunoglobulin A
Intestines
Mesangial Cells
Kidney
Occult Blood
Urinalysis
Tonsillectomy
Immunosuppressive Agents
Prednisolone
Plasma Cells
Galactose
Ileum
Proteinuria

Keywords

  • Crohn's disease
  • IgA nephropathy
  • IgA
  • IgA
  • Inflammatory bowel disease

ASJC Scopus subject areas

  • Nephrology

Cite this

The possible involvement of intestine-derived IgA1 : A case of IgA nephropathy associated with Crohn's disease. / Terasaka, Tomohiro; Uchida, Haruhito Adam; Umebayashi, Ryoko; Tsukamoto, Keiko; Tanaka, Keiko; Kitagawa, Masashi; Sugiyama, Hitoshi; Tanioka, Hiroaki; Wada, Jun.

In: BMC Nephrology, Vol. 17, No. 1, 122, 05.09.2016.

Research output: Contribution to journalArticle

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