A case of IgG4-related interstitial nephritis with ureteral obstruction: case report and literature review.
BMC Urol
; 23(1): 67, 2023 Apr 28.
Article
en En
| MEDLINE
| ID: mdl-37118801
ABSTRACT
BACKGROUND:
IgG4-related disease (IgG4-RD) is a newly discovered systemic disease that can affect any organ or tissue in the body. IgG4-related kidney disease (IgG4-RKD) is relatively rare but essential to IgG4-RD. However, there are few reports of IgG4-RD mimicking malignant ureteral tumors leading to hydronephrosis. We report here a rare case of IgG4-RD involving the ureter. CASE PRESENTATION An 87-year-old man presented to our nephrology department with anorexia, nausea, and acute kidney injury in November 2020. Urinary computed tomography (CT) examination revealed a right lower ureter mass with right renal and ureter hydronephrosis. The serum level of IgG4 was 1890 mg/dL, and the concurrently renal biopsy revealed extensive infiltration of IgG4-positive plasma cells in renal interstitium, which was diagnosed as IgG4-associated tubule-interstitial nephritis(IgG4-TIN). The renal function improved significantly after double-J tube implantation of the right ureter and moderate-dose hormone therapy. The serum IgG4 decreased to the normal range, and the right lower ureter mass almost disappeared after one year of low-dose hormone maintenance therapy.CONCLUSION:
IgG4-RD can present as a mass in the renal pelvis and (or) ureter, leading to hydronephrosis. Therefore, early recognition of this disease is significant. Most patients respond well to hormonal therapy to avoid surgical treatment due to misdiagnosis as malignant tumors, causing secondary harm to patients.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Obstrucción Ureteral
/
Enfermedad Relacionada con Inmunoglobulina G4
/
Hidronefrosis
/
Nefritis Intersticial
Tipo de estudio:
Diagnostic_studies
Límite:
Aged80
/
Humans
/
Male
Idioma:
En
Revista:
BMC Urol
Asunto de la revista:
UROLOGIA
Año:
2023
Tipo del documento:
Article
País de afiliación:
China