Immunoglobulin A nephropathy complicating ulcerative colitis

Abstract

Ulcerative colitis is rarely associated with immunoglobulin A nephropathy (IgAN). The development of IgA nephropathy complicates further the clinical course of patients with ulcerative colitis. A 72-year old man with a 30-year history of ulcerative colitis requiring colectomy and modest renal insufficiency secondary to complications of nephrolithiasis and renal artery stenosis developed glomerular hematuria, proteinuria and progressive renal failure. Percutaneous kidney biopsy revealed IgAN with extensive glomerular and interstitial sclerotic changes. After resection of a chronically infected ileo-rectal pouch, renal function improved, while hematuria and proteinuria gradually disappeared without specific treatment of the IgAN. The manifestations of IgAN complicating ulcerative colitis can be improved with effective treatment of the bowel disease even when there are extensive sclerotic changes in the kidneys.

The Histopathologic Spectrum of Kidney Biopsies in Patients with Inflammatory Bowel Disease

“…They described both clinical and pathologic remission of kidney disease concomitant with the treatment of symptoms of intestinal disease. Nineteen subsequent case reports in the literature have described IgAN in IBD (9,22,(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). A majority of these patients had IgAN during onset or exacerbation of IBD, as well as clinical remission of kidney disease in conjunction with successful treatment of bowel inflammation.…”

Renal manifestations and complications of inflammatory bowel disease

“…Reviewing the literature, at least 40 reports of IBD patients with GN have been identified; of these, 25 patients had UC, 13 CD, and two undetermined colitis, with the majority of reports suggesting that GN presented at the onset or during exacerbation of gastrointestinal tract disease 3, 49, 50. The clinical, laboratory, and histological findings in these cases were compatible with different types of GN, including: IgA nephropathy,50–54 IgM nephropathy,55 minimal change glomerulonephritis,49 membranous glomerulonephritis,56, 57 antiglomerular basement membrane glomerulonephritis,58 membranoproliferative glomerulonephritis,59, 60 mesangiocapillary glomerulonephritis,61 focal segmental glomerurosclerosis,62 and crescentic glomerulonephritis 63, 64…”

Linear IgA bullous dermatosis associated with ulcerative colitis: A case report and literature review

“…These indicate IgA autoantibody production in UC lesions because IgA autoantibodies for LABD belong to IgA1 . A case of IgA nephropathy complicating UC was reported, showing IgA deposition in glomerular mesangium and serum IgA with abnormal O ‐glycosylation and galactosylation . This indicates the possible autoreactive abnormal IgA synthesis in UC lesional mucosa .…”

“…A case of IgA nephropathy complicating UC was reported, showing IgA deposition in glomerular mesangium and serum IgA with abnormal O ‐glycosylation and galactosylation . This indicates the possible autoreactive abnormal IgA synthesis in UC lesional mucosa . In patients with UC, plasma cells secreting isotype‐switched IgG and related IgA1 autoantibody were present in lesional mucosa and blood, but not in normal mucosa, indicating that the IgG/IgA1‐producing clones might expand within lesional mucosa and disseminate via the blood.…”