Coexistence of immunoglobulin G4-related kidney disease and acute hematogenous disseminated pulmonary tuberculosis: a case report
BackgroundImmunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibrous inflammatory disease. Recently, an association between IgG4-RD and tuberculosis (TB) has been reported.Case summaryWe report a 56-year-old man complaining of a cough and poor appetite for 2 months and oliguria for 1...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-01-01
|
| Series: | Frontiers in Immunology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1493754/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841554006343680000 |
|---|---|
| author | Fangfang Zhou Hanqing Chu Youjun Xu Yena Zhang Kuibi Tan Jinxia Ge Ningjun Shao Qun Luo |
| author_facet | Fangfang Zhou Hanqing Chu Youjun Xu Yena Zhang Kuibi Tan Jinxia Ge Ningjun Shao Qun Luo |
| author_sort | Fangfang Zhou |
| collection | DOAJ |
| description | BackgroundImmunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibrous inflammatory disease. Recently, an association between IgG4-RD and tuberculosis (TB) has been reported.Case summaryWe report a 56-year-old man complaining of a cough and poor appetite for 2 months and oliguria for 1 day. The patient was diagnosed with TB due to a manifestation of lymphatic TB and the radiological alterations of acute miliary pulmonary TB. He also presented with greatly elevated serum creatinine, non-albumin proteinuria, immunoglobulin subgroup IgG4, and immunoglobulin free light chain (FLC) levels. A diagnosis of IgG4-RKD was suggested by a renal biopsy. We then administered the patient glucocorticoid and anti-TB treatment for 4 months. The patient’s renal function was completely restored and the manifestations of TB were alleviated.ConclusionThe necessity and complexity of differential diagnosis in patients with coexisting IgG4-RD and TB remains challenging. Early recognition and timely treatment are important for averting its progression. Long-term monitoring is required to assess for recurrence of IgG4-RD and TB activity. |
| format | Article |
| id | doaj-art-f7a5fd8e53da47ecba097eafe8fddd1c |
| institution | Kabale University |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-f7a5fd8e53da47ecba097eafe8fddd1c2025-01-09T05:10:23ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-01-011510.3389/fimmu.2024.14937541493754Coexistence of immunoglobulin G4-related kidney disease and acute hematogenous disseminated pulmonary tuberculosis: a case reportFangfang Zhou0Hanqing Chu1Youjun Xu2Yena Zhang3Kuibi Tan4Jinxia Ge5Ningjun Shao6Qun Luo7Department of Nephrology, Ningbo No.2 Hospital, Ningbo, Zhejiang, ChinaDepartment of Nephrology, Yuyao People’s Hospital, Ningbo, Zhejiang, ChinaDepartment of Nephrology, Ningbo No.2 Hospital, Ningbo, Zhejiang, ChinaDepartment of Pulmonary Tuberculosis, Ningbo No.2 Hospital, Ningbo, Zhejiang, ChinaDepartment of Nephrology, Ningbo No.2 Hospital, Ningbo, Zhejiang, ChinaDepartment of Nephrology, Ningbo No.2 Hospital, Ningbo, Zhejiang, ChinaDepartment of Nephrology, Ningbo No.2 Hospital, Ningbo, Zhejiang, ChinaDepartment of Nephrology, Ningbo No.2 Hospital, Ningbo, Zhejiang, ChinaBackgroundImmunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibrous inflammatory disease. Recently, an association between IgG4-RD and tuberculosis (TB) has been reported.Case summaryWe report a 56-year-old man complaining of a cough and poor appetite for 2 months and oliguria for 1 day. The patient was diagnosed with TB due to a manifestation of lymphatic TB and the radiological alterations of acute miliary pulmonary TB. He also presented with greatly elevated serum creatinine, non-albumin proteinuria, immunoglobulin subgroup IgG4, and immunoglobulin free light chain (FLC) levels. A diagnosis of IgG4-RKD was suggested by a renal biopsy. We then administered the patient glucocorticoid and anti-TB treatment for 4 months. The patient’s renal function was completely restored and the manifestations of TB were alleviated.ConclusionThe necessity and complexity of differential diagnosis in patients with coexisting IgG4-RD and TB remains challenging. Early recognition and timely treatment are important for averting its progression. Long-term monitoring is required to assess for recurrence of IgG4-RD and TB activity.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1493754/fullIgG4-related kidney diseasetuberculosiscase reportacute kidney injuryfree light chain (FLC) |
| spellingShingle | Fangfang Zhou Hanqing Chu Youjun Xu Yena Zhang Kuibi Tan Jinxia Ge Ningjun Shao Qun Luo Coexistence of immunoglobulin G4-related kidney disease and acute hematogenous disseminated pulmonary tuberculosis: a case report Frontiers in Immunology IgG4-related kidney disease tuberculosis case report acute kidney injury free light chain (FLC) |
| title | Coexistence of immunoglobulin G4-related kidney disease and acute hematogenous disseminated pulmonary tuberculosis: a case report |
| title_full | Coexistence of immunoglobulin G4-related kidney disease and acute hematogenous disseminated pulmonary tuberculosis: a case report |
| title_fullStr | Coexistence of immunoglobulin G4-related kidney disease and acute hematogenous disseminated pulmonary tuberculosis: a case report |
| title_full_unstemmed | Coexistence of immunoglobulin G4-related kidney disease and acute hematogenous disseminated pulmonary tuberculosis: a case report |
| title_short | Coexistence of immunoglobulin G4-related kidney disease and acute hematogenous disseminated pulmonary tuberculosis: a case report |
| title_sort | coexistence of immunoglobulin g4 related kidney disease and acute hematogenous disseminated pulmonary tuberculosis a case report |
| topic | IgG4-related kidney disease tuberculosis case report acute kidney injury free light chain (FLC) |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1493754/full |
| work_keys_str_mv | AT fangfangzhou coexistenceofimmunoglobuling4relatedkidneydiseaseandacutehematogenousdisseminatedpulmonarytuberculosisacasereport AT hanqingchu coexistenceofimmunoglobuling4relatedkidneydiseaseandacutehematogenousdisseminatedpulmonarytuberculosisacasereport AT youjunxu coexistenceofimmunoglobuling4relatedkidneydiseaseandacutehematogenousdisseminatedpulmonarytuberculosisacasereport AT yenazhang coexistenceofimmunoglobuling4relatedkidneydiseaseandacutehematogenousdisseminatedpulmonarytuberculosisacasereport AT kuibitan coexistenceofimmunoglobuling4relatedkidneydiseaseandacutehematogenousdisseminatedpulmonarytuberculosisacasereport AT jinxiage coexistenceofimmunoglobuling4relatedkidneydiseaseandacutehematogenousdisseminatedpulmonarytuberculosisacasereport AT ningjunshao coexistenceofimmunoglobuling4relatedkidneydiseaseandacutehematogenousdisseminatedpulmonarytuberculosisacasereport AT qunluo coexistenceofimmunoglobuling4relatedkidneydiseaseandacutehematogenousdisseminatedpulmonarytuberculosisacasereport |