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23-10-2024 | Primary Biliary Cholangitis | Case Report

Tubulointerstitial nephritis with IgM-positive plasma cells complicated by liver failure

Authors: Takashi Kudo, Daigo Nakazawa, Saori Nishio, Fumihiko Hattanda, Yusho Ueda, Junpei Yoshikawa, Satoka Shiratori-Aso, Sari Iwasaki, Takahiro Tsuji, Yasuni Nakanuma, Goki Suda, Koji Ogawa, Naoya Sakamoto, Tatsuya Atsumi

Published in: CEN Case Reports

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Abstract

Tubulointerstitial nephritis (TIN) is characterized by inflammation of the renal interstitium with the infiltration of immune cells, mainly consisting of T cells. Recently, patients with TIN with the predominant infiltration of immunoglobulin M (IgM)–positive plasma cells were reported, coined IgMPC-TIN. Here we report the case of a 70-year-old woman diagnosed with Fanconi syndrome and renal tubular acidosis. Renal biopsy revealed IgMPC-TIN. Her renal dysfunction and clinical findings improved after corticosteroid therapy. However, the patient died of progressive liver failure and spontaneous bacterial peritonitis. In laboratory tests, viral hepatitis was excluded, and autoantibodies associated with liver diseases were negative. Generally, IgMPC-TIN is often complicated by primary biliary cholangitis (PBC), whereas her autopsy revealed the local infiltration of IgM-positive plasma cells, obliterative portal venopathy, and nodular regenerative hyperplasia in liver. This case is the first demonstration that IgMPC-TIN is also seen in liver disease with nodular regenerative hyperplasia, although IgMPC-TIN is more common in anti-M2 antibody-positive disease.
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Literature
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go back to reference Nakanuma Y, Ohta G. Nodular hyperplasia of the liver in primary biliary cirrhosis of early histological stages. Am J Gastroenterol. 1987;82:8–10.PubMed Nakanuma Y, Ohta G. Nodular hyperplasia of the liver in primary biliary cirrhosis of early histological stages. Am J Gastroenterol. 1987;82:8–10.PubMed
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go back to reference Nodular Regenerative Hyperplasia (2012) LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases Nodular Regenerative Hyperplasia (2012) LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases
Metadata
Title
Tubulointerstitial nephritis with IgM-positive plasma cells complicated by liver failure
Authors
Takashi Kudo
Daigo Nakazawa
Saori Nishio
Fumihiko Hattanda
Yusho Ueda
Junpei Yoshikawa
Satoka Shiratori-Aso
Sari Iwasaki
Takahiro Tsuji
Yasuni Nakanuma
Goki Suda
Koji Ogawa
Naoya Sakamoto
Tatsuya Atsumi
Publication date
23-10-2024
Publisher
Springer Nature Singapore
Published in
CEN Case Reports
Electronic ISSN: 2192-4449
DOI
https://doi.org/10.1007/s13730-024-00932-9

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