J Rheum Dis.  2013 Aug;20(4):261-265. 10.4078/jrd.2013.20.4.261.

A Case of Behcet's Disease Complicated by IgA Nephropathy

• Ryu YS
• Jeon CH
• Jin SY

• KMID: 2297543
• DOI: http://doi.org/10.4078/jrd.2013.20.4.261

Abstract

Behcet's disease (BD) is a rare, multisystemic disorder characterized by vasculitis. Although renal involvement rarely coexists with BD, several types of renal involvements have been reported: amyloidosis, glomerulonephritis and vascular involvement. Herein, we report a rare case of BD complicated with IgA nephropathy (IgAN). A 42-year-old woman visited the hospital due to joint pains and painful subcutaneous nodules. Based on her medical history of recurrent orogenital ulcers, arthritis, enteral ulcers, erythema nodosum-like skin lesions, and a positive pathergy test, we diagnosed her with BD. To evaluate proteinuria, we performed a renal biopsy. The patient was diagnosed with BD complicated with IgAN, and treated with a low dosage of steroid, colchicine, as well as angiotensin II type I receptor blockers. Although renal involvement in BD is rare, it is important to periodically perform renal function assessments in patients with BD involving abnormal urine results.

Keyword

Behcet's disease; Proteinuria; IgA nephropathy

MeSH Terms

Adult
Angiotensin II Type 1 Receptor Blockers
Arthralgia
Arthritis
Biopsy
Colchicine
Erythema Nodosum
Female
Glomerulonephritis
Glomerulonephritis, IGA
Humans
Immunoglobulin A
Proteinuria
Skin
Ulcer
Vasculitis
Colchicine
Immunoglobulin A

Figure

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  Figure 1. Each glomerulus was mildly increased in size and focally increased in mesangial cellularity (PAS, ×100).

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  Figure 2. Light microscopic finding of renal biopsy. A focus of segmental mesangial expansion by mild mesangial hypercellu-larity is seen with Bowman's adhesion (PAS, ×400).

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  Figure 3. Immunofluorescent finding. Strong positive staining of IgA is noted in the mesangium and focal peripheral capillary loops (DIF for IgA, ×400).

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  Figure 4. Ultrastructural finding. Multiple mesangial electron dense deposits are presentedin the mesangial region with suben-dothelial mesangial interposition (original magnification, ×2,500).

Reference

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