Behçet’s disease complicated by IgA nephropathy with nephrotic syndrome

Hashimoto, Tatsuo; Toya, Yoshiyuki; Kihara, Minoru; Yabana, Machiko; Inayama, Yoshiaki; Tanaka, Kenichiro; Iwatsubo, Kousaku; Yanagi, Mai; Oshikawa, Jin; Kokuho, Toshiharu; Kuji, Tadashi; Yoshida, Shinichiro; Tamura, Kouichi; Umemura, Satoshi

doi:10.1007/s10157-008-0029-6

Cited by 7 publications

(3 citation statements)

References 16 publications

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“…The first presentation is often incidentally found proteinuria or haematuria caused by glomerulonephritis [7][8][9]. Crescenteric and proliferative glomerulonephritis, as well as IgA nephritis, have also been reported in some cases [7,8,10,11]. Moreover, nephrotic syndrome might be present in over 83% of patients with amyloidosis, and renal failure is common at the time of diagnosis [7,8,10].…”

Section: Discussionmentioning

confidence: 99%

A severe renal bleeding as a complication of coumarin therapy in Behçet's disease

Remková

Milatová²,

Fuchsbergerová³

2010

Blood Coagulation &Amp; Fibrinolysis

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Behçet's disease is a systemic inflammatory disease, which predisposes patients to venous or arterial thrombosis. We report a case of 41-year-old patient who presented for several years with recurrent fevers, arthralgias, episodes of skin eruptions and recurrent bilateral deep venous ileofemoral thromboses, extending into the inferior vena cava, despite the oral anticoagulant therapy. Additionally, he also reported recurrent aphthous oral and genital lesions, and eye problems. A laboratory picture of chronic inflammation, normocytic anaemia and a finding of lupus anticoagulant/antiphospholipid antibodies were observed. PET raised a high suspicion of vasculitic PTT-lupus anticoagulant process, involving the large vessels. During an anticoagulant therapy by warfarin (dose in upper limit of therapeutic range), the left kidney had to be removed because of acute retroperitoneal haemorrhage. On histologic examination, the picture of nephritis was described. A detailed retrospective reevaluation of complex history as well as other clinical findings strongly raised the suspicion of a systemic vasculitic syndrome, such as Behçet's disease, accompanied by antiphospholipid syndrome. The patient responded well to the combination of colchicine and anticoagulant therapy by low-molecular-weight heparin. The episodes of fever, skin eruptions and other symptoms disappeared. We assume that this is a case of an unusual course of Behçet's disease presenting with a rare kidney involvement. Kidney disorder complicated the oral anticoagulant therapy for recurrent venous thromboses and led to the excessive renal bleeding, requiring nephrectomy. Recognition that nephritis is associated with Behçet's disease may be useful to prevent severe renal bleeding in relation to anticoagulant therapy.

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Section: Discussionmentioning

confidence: 99%

A severe renal bleeding as a complication of coumarin therapy in Behçet's disease

Remková

Milatová²,

Fuchsbergerová³

2010

Blood Coagulation &Amp; Fibrinolysis

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“…However, emerging data have suggested that the pleiotropic eVects of statins may extend to a larger number of disorders, as evidenced by (1) improved quality of life, decreased inXammation and enhanced response to topical steroid therapy in patients with psoriaris and psoriatic arthritis [75,76]; (2) decreased postinXammatory vascular remodeling and endothelial dysfunction in children and young adults with Kawasaki disease [77,78]; (3) improved disease activity in patients with active ankylosing spondylitis [79]; (4) improved endothelial function and decreased proteinuria in Behcet's disease patients [80,81]; and (5) a case of To determine the eVects of Xuvastatin on prothrombotic and pro-inXammatory markers therapy-refractory juvenile idiopathic arthritis treated with oral atorvastatin [82]. It is important to note that although rare, adverse reactions of statins have included the triggering of de novo autoimmune disorders, in particular inXammatory myopathies.…”

Section: Discussionmentioning

confidence: 99%

The pleiotropic effects of the hydroxy-methyl-glutaryl-CoA reductase inhibitors in rheumatologic disorders: a comprehensive review

2011

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The hydroxy-methyl-glutaryl-CoA reductase inhibitors (statins) are used extensively in the treatment for hyperlipidemia. They have also demonstrated a benefit in a variety of other disease processes, including a wide range of rheumatologic disorders. These secondary actions are known as pleiotropic effects. Our paper serves as a focused and updated discussion on the pleiotropic effects of statins in rheumatologic disorders and emphasizes the importance of randomized, placebo-controlled trials to further elucidate this interesting phenomenon.

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“…The primary pathologic changes in BD are vasculitis-related; renal involvement in BD is less frequent and often less severe than in other types of vasculitis (2). The frequency of renal problems among BD patients has been reported to vary between 0% and 55% (3) …”

Section: Introductionmentioning

confidence: 99%