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Lupus nephritis with massive subendothelial deposits in a patient with autoimmune hepatitis-related cirrhosis
- Source :
- Human Pathology: Case Reports, Vol 13, Iss, Pp 27-32 (2018)
- Publication Year :
- 2018
- Publisher :
- Elsevier, 2018.
-
Abstract
- A 72-year-old Japanese woman with a history of autoimmune hepatitis-associated liver cirrhosis and portosystemic shunt was admitted to our hospital for evaluation of renal dysfunction, nephrotic range proteinuria, a high titer of anti-double-stranded DNA antibody, and hypocomplementemia. Renal biopsy showed massive subendothelial deposits (wire loop lesions), and class IV-G (A/C) lupus nephritis was diagnosed. Immunosuppressants, such as steroids (including intravenous methylprednisolone pulse therapy) and mycophenolate mofetil, could not prevent renal dysfunction. It was assumed that circulating immune deposits produced in the gastrointestinal tract entered the systemic circulation from the portal vein via the portosystemic shunt without hepatic clearance, resulting in massive subendothelial and mesangial accumulation compared to lupus nephritis patients without a shunt and causing renal injury. Keywords: Lupus nephritis, Systemic lupus erythematosus, Autoimmune hepatitis-associated liver cirrhosis, Portosystemic shunt, Wire loop lesion
- Subjects :
- 030203 arthritis & rheumatology
medicine.medical_specialty
Cirrhosis
medicine.diagnostic_test
business.industry
030232 urology & nephrology
Lupus nephritis
Autoimmune hepatitis
medicine.disease
Gastroenterology
Pathology and Forensic Medicine
End stage renal disease
03 medical and health sciences
0302 clinical medicine
Internal medicine
Membranoproliferative glomerulonephritis
medicine
lcsh:Pathology
Rapidly progressive glomerulonephritis
Renal biopsy
Portosystemic shunt
business
lcsh:RB1-214
Subjects
Details
- Language :
- English
- ISSN :
- 22143300
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- Human Pathology: Case Reports
- Accession number :
- edsair.doi.dedup.....ea2eb2275fc8946a5bd288eb5956c259