PT  - JOURNAL ARTICLE
AU  - Atsuki Ohashi
AU  - Jiro Kumagai
AU  - Kiyotaka Nagahama
AU  - Hajime Fujisawa
TI  - Case of immunotactoid glomerulopathy showing high responsiveness to steroids therapy despite severe pathological features
AID  - 10.1136/bcr-2019-229751
DP  - 2019 Jul 01
TA  - BMJ Case Reports
PG  - e229751
VI  - 12
IP  - 7
4099  - http://casereports.bmj.com/content/12/7/e229751.short
4100  - http://casereports.bmj.com/content/12/7/e229751.full
SO  - BMJ Case Reports2019 Jul 01; 12
AB  - A 72-year-old woman presented with nephrotic proteinuria and moderate haematuria. Renal pathology was compatible with immunotactoid glomerulopathy (ITG), for which there is no consensus for appropriate therapy. We, therefore, postponed immunosuppressive therapy. After 4 years, the patient’s renal function started to decline and renal pathology was re-evaluated, revealing a pathological change from mesangial proliferative glomerulonephritis to endocapillary proliferative glomerulonephritis. Treatment with oral prednisolone (30 mg/day) was initiated. Within 5 weeks, complete remission of proteinuria was obtained (proteinuria 6.02 g/gCr to 0.12 g/gCr), and the patient’s renal function stabilised. Generally, responsiveness to immunosuppressive therapy is poor in patients with ITG, and the present case represented a very rare clinical course. Some previous cases have indicated susceptibility to the therapy, regardless of the severity of renal damage. As a possible distinct entity that determines susceptibility to immunosuppressive therapy, we suggest the presence of a latent lymphoproliferative disease with no significant haematological symptoms.