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2015 ; 4
(1
): 24-30
Nephropedia Template TP
gab.com Text
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English Wikipedia
A case of membranoproliferative glomerulonephritis and AA amyloidosis complicated
with pulmonary nontuberculous mycobacterial infection
#MMPMID28509264
Tsuji K
; Arai H
; Furusu A
; Torigoe K
; Tokuyama A
; Muraya Y
; Nakashima M
; Taguchi T
; Obata Y
; Nishino T
; Kohno S
CEN Case Rep
2015[May]; 4
(1
): 24-30
PMID28509264
show ga
A 75-year-old man was diagnosed with pulmonary nontuberculous mycobacterial (NTM)
infection in February 2005 and was treated with rifampicin, ethambutol, and
clarithromycin. However, the infection was resistant to treatment, and his chest
radiograph showed an abnormality that gradually seemed to aggravate. The
patient's sputum was positive for Mycobacteria. Moreover, the patient had dyspnea
and an underlying chronic inflammation in the lungs. He visited our hospital
because of dyspnea and leg edema in June 2011. Laboratory evaluation on admission
revealed proteinuria (6 g/day) and decreased serum total protein (5.8 g/dL) and
albumin (1.6 g/dL) levels, indicating nephrotic syndrome. Percutaneous renal
biopsy revealed membranoproliferative glomerulonephritis (MPGN) in the acute
stage and AA amyloidosis of mild degree. AA amyloidosis was also diagnosed
histologically on gastric and colonic biopsy, in addition to renal biopsy. His
renal function decreased gradually, and therefore, he underwent hemodialysis
therapy in January 2012. However, his gastrointestinal-related symptoms
persisted, and his appetite diminished, because of which he had become severely
malnourished; he died 8 months later. This is a rare case of a patient with two
different renal lesions (MPGN and AA amyloidosis) complicated with NTM. Our case
suggests that MPGN and amyloidosis should be considered in elderly patients with
nephrotic syndrome onset and chronic inflammation.