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Clin Nephrol ; 87 (2017)(4): 196-201, 2017 Apr.
Article in English | MEDLINE | ID: mdl-28102816

ABSTRACT

AIM: Membranous nephropathy and minimal change disease (MCD) have been involved in mercury-induced nephrotic syndrome. IgA nephropathy is not known to be a common pathological type. In the present article, we report a case of IgA nephropathy with MCD following exposure to mercury-containing skin lightening cream. MATERIAL AND METHODS: The patient was a 39-year-old woman who presented with nephrotic syndrome. She had a 6-month history of using as many as 8 kinds of skin-lightening creams, and urinary mercury excretion was high. Renal biopsy revealed IgA nephropathy with MCD. The use of cosmetics was stopped and chelation therapy was given. After 4 courses (1 month) of chelation therapy, there was a complete remission of proteinuria and hematuria, and urine tests remained normal during the 5-year follow-up period. RESULTS AND CONCLUSIONS: The unique clinical and pathological features of IgA nephropathy with MCD had raised the controversial question of whether MCD and IgA deposition are separate entities or a common pathophysiology. Repeated renal biopsy and similar cases were helpful and should be carried out as far as possible.
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Subject(s)
Glomerulonephritis, IGA/chemically induced , Mercury Poisoning/complications , Nephrosis, Lipoid/chemically induced , Skin Lightening Preparations/poisoning , Adult , Chelating Agents/therapeutic use , Female , Glomerulonephritis, IGA/pathology , Glomerulonephritis, IGA/therapy , Hematuria/etiology , Humans , Kidney/pathology , Kidney/ultrastructure , Mercury Poisoning/drug therapy , Nephrosis, Lipoid/pathology , Nephrosis, Lipoid/therapy , Nephrotic Syndrome/etiology , Nephrotic Syndrome/therapy , Proteinuria/etiology , Remission Induction , Skin Lightening Preparations/chemistry , Unithiol/therapeutic use
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