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2015 ; 4
(2
): 157-161
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Clinical remission of IgA nephropathy in an HIV-positive patient after combined
treatment with tonsillectomy and steroid pulse therapy
#MMPMID28509091
Tada M
; Masumoto S
; Hinoshita F
CEN Case Rep
2015[Nov]; 4
(2
): 157-161
PMID28509091
show ga
Various renal diseases other than human immunodeficiency virus (HIV)-associated
nephropathy, including IgA nephropathy (IgAN), have been recently reported to
cause chronic kidney disease and end-stage renal disease in HIV-infected
patients. The case of a 37-year-old HIV-infected male diagnosed as having IgAN
with proteinuria and microscopic hematuria that was successfully treated with
tonsillectomy and steroid pulse therapy in combination, resulting in
disappearance of urinary abnormalities (clinical remission), is reported, the
first such case in the literature. A renal biopsy revealed mesangial
proliferation associated with mesangial deposition of IgA and C3, consistent with
IgAN. Antiretroviral therapy and angiotensin receptor blocker therapy did not
improve his proteinuria. Therefore, he underwent tonsillectomy and steroid pulse
therapy, and clinical remission was successfully achieved with no opportunistic
infections. Clinical remission has continued for more than 3 years even after
discontinuation of steroid therapy. It appears that combined treatment with
tonsillectomy and steroid pulse therapy can be a good choice in managing
HIV-infected patients with IgAN as long as secondary infection is strictly and
continuously monitored.