Autoimmune hepatitis in a patient with immunoglobulin A nephropathy:A case report

查看全文 作　　者：You Hyun [1]Jeon;Da Woon [1]Kim;So Jeong [2]Lee;Young Joo [3]Park;Hyo Jin [4]Kim;Miyeun [3]Han;Il Young [5]Kim;Dong Won [5]Lee;Sang Heon [4]Song;Soo Bong [5]Lee;Eun Young [4]Seong 机构地区：[1]Department of Internal Medicine,Pusan National University School of Medicine,Busan 49241,South Korea;[2]Department of Pathology,Pusan National University Hospital,Busan 49241,South Korea;[3]Division of Gastroenterology,Department of Internal Medicine,Biomedical Research Institute,Pusan National University Hospital,Busan 49241,South Korea;[4]Division of Nephrology,Department of Internal Medicine,Biomedical Research Institute,Pusan National University Hospital,Busan 49241,South Korea;[5]Division of Nephrology,Department of Internal Medicine,Pusan National University Yangsan Hospital,Yangsan 626-770,South Korea 出　　处：《World Journal of Clinical Cases》索引2020年第8卷第17期,共7页 基　　金：Pusan National University Hospital Education and Research Team,No 219。 摘　　要：BACKGROUND Immunoglobulin A nephropathy(IgAN)is the most commonly encountered glomerular disease in Asian countries.It has a broad clinical presentation,and it is frequently associated with other conditions.Chronic liver disease is well recognized as the leading cause of secondary IgAN.However,cases of IgAN associated with autoimmune hepatitis(AIH)have seldom been reported.CASE SUMMARY A 63-year-old Korean woman was admitted to Pusan National University Hospital for an evaluation of abdominal pain and elevated liver enzymes.Two weeks prior,she had presented to our hospital with proteinuria of approximately 1350 mg/d and hematuria and was diagnosed with IgAN.Autoimmune profiles were highly positive for antinuclear antibodies,and symptoms related to portal hypertension including ascites and peripheral edema were present.A diagnosis of AIH was made according to the simplified scoring system of the International Autoimmune Hepatitis Group.Despite immunosuppression with prednisolone and azathioprine,rapid deterioration of liver function led to end-stage liver disease.After a living-donor liver transplantation,liver function gradually improved,and she had maintained stable liver and kidney function at the six months follow-up.CONCLUSION Cases of secondary IgAN with chronic liver disease have been frequently reported in the literature but are rarely associated with AIH.We encountered an IgAN patient with concurrent progressive liver failure due to AIH. 关 键 词：Immunoglobulin A nephropathy Secondary immunoglobulin A nephropathy Autoimmune hepatitis Liver transplantation Case report