Korean J Nephrol.
2010 Jan;29(1):125-130.
Development of IgA Nephropathy after Clinical Remission of Dense Deposit Disease
- Affiliations
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- 1The Institute of Kidney Disease, Department of Pathology, Yonsei University College of Medicine, Seoul, Korea. jeong10@yuhs.ac
- 2The Institute of Kidney Disease, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
- 3Department of Pathology, Kangnam CHA Hospital, Pochon CHA University College of Medicine, Seongnam, Korea.
- 4Division of Renal Pathology, Clinical Research Center, Chiba-East National Hospital, Chiba, Japan.
- 5Department of Pediatrics, Kwandong University College of Medicine, Koyang, Korea.
Abstract
- Dense deposit disease (DDD) is a rare primary glomerulonephritis characterized by continuous band- like intramembranous dense deposits detectable on electron microscopy. We describe a case of DDD with sequential mesangial proliferative glomerulonephritis, membranoproliferative glomerulonephritis, minor glomerular alterations, and a second round of mesangial proliferative glomerulonephritis during a 13-year period. Electron dense deposits were typical of DDD in the first and second biopsies taken one year apart. However, deposits dissolved and the glomerular cellularity and basement membrane normalized with clinical remission, which was achieved by a course of immunosuppressive therapy lasting seven years. The fourth biopsy was performed due to recurrence of microscopic hematuria and showed predominant mesangial IgA deposits without glomerular capillary alteration, which was interpreted as development of IgA nephropathy after remission of DDD or coexistence with nearly healed DDD in this patient.
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