Secondary IgA nephropathy presenting as nephrotic syndrome with glomerular crescentic changes and acute renal failure in a patient with autoimmune hepatitis

Autoimmune hepatitis in a patient with immunoglobulin A nephropathy: A case report

BACKGROUND

Immunoglobulin A nephropathy (IgAN) is the most commonly encountered glomerular disease in Asian countries. It has a broad clinical presentation, and it is frequently associated with other conditions. Chronic liver disease is well recognized as the leading cause of secondary IgAN. However, cases of IgAN associated with autoimmune hepatitis (AIH) have seldom been reported.

CASE SUMMARY

A 63-year-old Korean woman was admitted to Pusan National University Hospital for an evaluation of abdominal pain and elevated liver enzymes. Two weeks prior, she had presented to our hospital with proteinuria of approximately 1350 mg/d and hematuria and was diagnosed with IgAN. Autoimmune profiles were highly positive for antinuclear antibodies, and symptoms related to portal hypertension including ascites and peripheral edema were present. A diagnosis of AIH was made according to the simplified scoring system of the International Autoimmune Hepatitis Group. Despite immunosuppression with prednisolone and azathioprine, rapid deterioration of liver function led to end-stage liver disease. After a living-donor liver transplantation, liver function gradually improved, and she had maintained stable liver and kidney function at the six months follow-up.

CONCLUSION

Cases of secondary IgAN with chronic liver disease have been frequently reported in the literature but are rarely associated with AIH. We encountered an IgAN patient with concurrent progressive liver failure due to AIH.

Partial Orchiectomy for the Treatment of a Benign Sclerosing Sertoli Cell Tumor: A Report of a Rare Tumor in Association With Testicular Microlithiasis

The diagnosis of a testicular sclerosing Sertoli cell tumor is rare. Approximately 17 cases have been previously described in the literature worldwide. We present a case and review the evaluation and surgical management of a sclerosing Sertoli cell tumor presenting in a 26 year-old African-American adult, in association with testicular microlithiasis and oligospermia. Imaging techniques and the pathological assessment will be reviewed.