IgA Nephropathy in a Patient Presenting with Pseudotumor Cerebri

Ahmed, Umair; Bacaj, Patrick; Iqbal, Hafiz Imran; Onder, Songul

doi:10.1155/2016/5273207

Cited by 4 publications

(11 citation statements)

References 25 publications

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“…In literature, association of kidney function and CSF pressure has been discussed but only one case of an IIH with comorbid immune-complex IgA glomerulonephritis has been published [ 1 ]. In this special case, the immune-complex glomerulonephritis had a severe course.…”

Section: Discussionmentioning

confidence: 99%

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Case series of idiopathic intracranial hypertension in three patients with immune-complex glomerulonephritis

2021

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Background Idiopathic intracranial hypertension (IIH) is defined by an increased cerebrospinal fluid pressure in the absence of inflammation, structural obstructions, or mass lesions. Although the underlying pathogenesis of IIH is not fully understood, associations with specific risk factors as obesity, obstruction of cerebral venous sinuses, medications, endocrine or systemic conditions and chronic kidney disease have been described. Immune-complex glomerulonephritis as IgA-nephropathy is a frequent cause of chronic kidney failure, which was reported previously in one IIH patient. To date, there is no knowledge about the variable relation of immune-complex nephritis, kidney function and the course of IIH. Case presentation We report three cases (two females) of concurrent diagnosis of IIH and immune-complex glomerulonephritis. All patients presented with typical IIH symptoms of headache and visual disturbances. Two patients had been diagnosed with IgA-nephropathy only few weeks prior to IIH diagnosis. The third patient had been diagnosed earlier with terminal kidney failure due to a cryoglobulin glomerulonephritis. Conclusion We propose a possible link between renal deposition of immune-complexes and increased cerebrospinal fluid pressure. Pathophysiological hypotheses and clinical implications are discussed. We recommend clinical awareness and further systematic research to obtain more information on the association of IIH and immune-complex glomerulonephritis.

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Section: Discussionmentioning

confidence: 99%

“…Only one case of an adult with IIH and comorbid immune-complex-glomerulonephritis has been published [ 1 ]. Here, we report three cases of patients with immune-complex glomerulonephritis and coincident diagnosis of IIH and discuss clinical relevance and implications.…”

Section: Introductionmentioning

confidence: 99%

Case series of idiopathic intracranial hypertension in three patients with immune-complex glomerulonephritis

2021

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“…In contrast, risk factors for secondary intracranial hypertension include renal disease, cerebral venous sinus thrombosis, growth hormone therapy, intracranial haemorrhage, malignancy, vitamin A excess or deficiency, vitamin D deficiency, systemic inflammatory conditions such as systemic lupus erythematosus, and medications such as tetracyclines and steroids 1–3 . Secondary intracranial hypertension associated with renal failure is rare 3–5 . Our patient had multiple potential contributing factors for intracranial hypertension: obesity, adolescence, female gender, renal disease, hypervitaminosis A and vitamin D deficiency.…”

Section: Discussionmentioning

confidence: 81%

“…The aetiology of renal failure's association with secondary intracranial hypertension remains unclear; however, postulated causes include medications, weight gain and anaemia 5 . Nutritional vitamin D deficiency, which occurs more commonly in CKD patients, is also known to be associated with secondary intracranial hypertension 2,6 .…”

Section: Discussionmentioning

confidence: 99%

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Papilloedema and renal failure in an adolescent presenting to the emergency department

Vega

Valentini

Sethuraman

et al. 2021

J Paediatrics Child Health

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Papilledema and retinopathy lead to diagnosis of IgA nephropathy: a case report

Kwan

Lanzo

Ramsey

et al. 2023

Therapeutic Advances in Rare Disease

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This case features a young healthy male who was diagnosed with immunoglobulin A (IgA) nephropathy after presenting with blurry vision that was caused by hypertensive retinopathy and papilledema. In this report, we examine the relationship between hypertension and increased intracranial pressure (ICP), along with the ocular signs of IgA nephropathy that may present in the setting of kidney disease. Plain Language Summary Immunoglobulin A (IgA) nephropathy is an immune-mediated inflammatory condition that affects the kidneys and is characterized by deposits of IgA antibodies across the body. Nephropathy in general is defined as the deterioration of kidney function. Hypertension is a common complication because of the resultant kidney damage. IgA can also deposit widely across the body, including within the eyes, and may lead to various inflammatory manifestations affecting the front and back of the eyes. We present a case of a 38-year-old male with 2 weeks of worsening vision and headaches. His blood pressure was extremely high (206/116 mmHg) and he was found to have acute kidney injury. Examination of his eye revealed hypertensive retinopathy but also significant swelling of both of his optic discs, concerning for increased intracranial pressure (ICP), which is unusual in a young, otherwise healthy male. The investigation for the cause of increased ICP led to the diagnosis of IgA nephropathy. Treatment of his increased ICP and blood pressure resulted in improvement of his vision. It is important to consider increased ICP as a cause of optic disc swelling in patients with very high blood pressures. Prompt evaluation and management of elevated ICP is important to preserve vision, prevent brain complications and diagnose the underlying disease process. Especially important is the communication and coordination across medical specialties to ensure safe treatment given the multisystem organ involvement. In this article, we also review the eye findings associated with IgA nephropathy, as well as other immune-mediated complications of this rare disease.

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IgA Nephropathy in a Patient Presenting with Pseudotumor Cerebri

Cited by 4 publications

References 25 publications

Case series of idiopathic intracranial hypertension in three patients with immune-complex glomerulonephritis

Case series of idiopathic intracranial hypertension in three patients with immune-complex glomerulonephritis

Papilloedema and renal failure in an adolescent presenting to the emergency department

Papilledema and retinopathy lead to diagnosis of IgA nephropathy: a case report

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