Polycythemia vera associated with IgA nephropathy: A case report and literature review

Abstract

Abstract. A case of polycythemia vera (PV) associated with immunoglobulin A nephropathy (IgAN) in a 57-year-old man is described. The patient had a mild enlargement of the kidneys and elevated serum creatinine level, whereas the glomerular filtration rate was normal. Pathological observation under a light microscope showed mild mesangial hyperplasia. The urinary protein level was found to be positively correlated with changes in blood cell counts. After controlling blood pressure, anti-platelet, hydroxyurea treatment, the patient's proteinuria decreased and renal function remained in the normal range. PV associated with renal disease is rare and generally considered to be associated with hypervolemia or high-viscosity-induced renal hyperperfusion and hyperfiltration. This is a rare case of PV associated with IgAN without a high filtration rate. A review of the clinical features of PV associated with renal disease from previous literature was also conducted. The histological results of the cases varied and included IgAN, focal segmental glomerulosclerosis and membranoproliferative glomerulonephritis.

Idiopathic erythrocytosis in IgA nephropathy

“…[123456] The other renal lesions associated with polycythemia were focal segmental glomerulosclerosis, membranoproliferative glomerulonephritis, and rapidly progressive glomerulonephritis. Furthermore, of the ten cases of polycythemia associated with IgAN described so far, all happen to be males.…”

Kidney transplantation in a patient with polycythemia vera

“…Only 23 patients of PV associated with renal disease have been reported in the literature. IgA nephropathy and focal segmental glomerulosclerosis were the most predominant histopathological features (3,5,(8)(9)(10)(11)(12)(13)(14)(15)(16). Other histopathological features included membranoproliferative glomerulonephritis and rapidly progressive glomerulonephritis (3,17).…”

“…IgA nephropathy and focal segmental glomerulosclerosis were the most predominant histopathological features (3,5,(8)(9)(10)(11)(12)(13)(14)(15)(16). Other histopathological features included membranoproliferative glomerulonephritis and rapidly progressive glomerulonephritis (3,17). In contrast to most reports, our patient had sub-nephrotic proteinuria with 1960 g/d (2,3,5,(8)(9)(10)(11)(12)(13)(14)(15)16).…”

“…Hydroxyurea in addition to phlebotomy is prescribed for those with a history of thrombosis or who are more than 60-year old. Renal diseases in PV are rare, and few cases of renal failure with glomerulonephritis have been reported (2,3).…”

Polycythemia Vera Associated with IgA Nephropathy: A Case Report

“…Hastaların yirmibir tanesine biyopsi uygulanmış. Biyopsi sonuçları sekiz IgA nefropatisi, fokal segmental glomerüloskleroz, hızlı ilerleyen glomerülonefrit olarak saptanmış (21). Bu birlikteliğin olası sebepleri tartışılmış, fakat kesin bir patogenez bulunamamış.…”