Korean J Med.  2008 May;74(5):546-550.

Membranous glomerulonephritis associated with pancreatic tuberculosis

• Lee JH
• Song JH
• Park YR
• Kim JY
• Yang CW
• Kim YS
• Bang BK

Abstract

A 51-year old man presented with generalized edema for 10 days. He was admitted to the hospital for a renal biopsy, and a pancreatic mass was incidentally detected by ultrasonography. The renal biopsy was consistent with membranous glomerulonephritis and the pancreas biopsy revealed chronic granulomatous inflammation with multinucleated giant cells, which was suggestive of tuberculosis of the pancreas. The patient was initially treated with a steroid and anti-tuberculosis drugs, but the proteinuria in the nephrotic range persisted throughout the 3-month follow-up. With the presumed diagnosis of tuberculosis-induced membranous nephropathy, immunosuppressant therapy was stopped and anti-tuberculosis drugs were administered for 31 months. With anti-tuberculous treatment, the proteinuria was reduced from 22 g/day to 0.57 g/day. A follow-up abdominal CT revealed a marked reduction in the size of the pancreatic mass. This finding suggests that the membranous nephropathy in our case was related to the pancreatic tuberculosis rather than it being related to primary nephrotic syndrome.

Keyword

Pancreatic tuberculosis; Membranous glomerulonephritis; Nephrotic syndrome

MeSH Terms

Biopsy
Edema
Follow-Up Studies
Giant Cells
Glomerulonephritis, Membranous
Humans
Inflammation
Nephrotic Syndrome
Pancreas
Proteinuria
Tuberculosis