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IgG4-Related Tubulointerstitial Nephritis Accompanied by Henoch-Schonlein Purpura

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¾çÇö(Yang Hyun) - °¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
ÃÖ¼ö°æ(Choi Soo-Kyoung) - °¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
±èº¸°æ(Kim Bo-Kyoung) - °¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
À¯Áö¿¬(Yoo Ji-Yeon) - °¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
°íÀº½Ç(Koh Eun-Sil) - °¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
ÀåÀ±½Ä(Chang Yoon-Sik) - °¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
Á¤¼ºÁø(Chung Sung-Jin) - °¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç

Abstract

Tubulointerstitial nephritis is one of the common manifestations of immunoglobulin G (IgG)4-related disease; however, among all cases of tubulointerstitial nephritis undergoing renal biopsies, IgG4-related tubulointerstitial nephritis seems to be relatively rare because of its trivial urinary findings. A previously healthy 54-year-old man was referred to our clinic with a 4-week history of lower leg purpura and renal dysfunction. A kidney biopsy was planned because of bilateral renomegaly, by imaging studies, and elevated serum creatinine levels. Pathological findings in the kidney showed prominent infiltration of IgG4-postive plasma cells in the tubulointerstitium, but not the glumeruli. A skin biopsy revealed leukocytoclastic vasculitis, accompanied by deposition of IgA and C3 in the vascular wall, indicating Henoch-Schonlein purpura (HSP). Although cases of combined IgG4-related disease and microvasculitis, including HSP, are extremely rare, the possibility of an association between two diseases deserves attention.

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Immunoglobulin G4, Nephritis, Interstitial, Henoch-Schonlein purpura
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