IgG4-related chronic tubulointerstitial nephritis without autoimmune pancreatitis and the time course of renal function

Intern Med. 2010;49(15):1593-8. doi: 10.2169/internalmedicine.49.3787. Epub 2010 Aug 2.

Abstract

We report an elderly man with chronic tubulointerstitial nephritis (TIN) showing a high serum immunoglobulin G4 (IgG4) concentration. His serum creatinine (Scr) level had gradually increased from 0.9 mg/dL to 5.6 mg/dL over 18 months. Renal biopsy showed marked IgG4-positive plasma cell infiltration in the interstitium without glomerular abnormalities and IgG4-related TIN was diagnosed. Oral prednisolone reduced his Scr and IgG4 levels immediately. The present case indicates that IgG4-related TIN can not only progress rapidly but also chronically over a long period without significant urinary abnormalities, and we should consider hidden IgG4-related TIN in cases of chronic renal insufficiency.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Autoimmune Diseases* / blood
  • Autoimmune Diseases* / diagnosis
  • Chronic Disease
  • Humans
  • Immunoglobulin G / blood*
  • Kidney / physiology*
  • Kidney Function Tests / trends
  • Male
  • Nephritis, Interstitial / blood
  • Nephritis, Interstitial / diagnosis*
  • Pancreatitis* / blood
  • Pancreatitis* / diagnosis
  • Time Factors

Substances

  • Immunoglobulin G