Case Report

CEN Case Reports

, Volume 3, Issue 1, pp 118-122

Open Access This content is freely available online to anyone, anywhere at any time.

Five cases of tonsillectomy and steroid pulse therapy for recurrent immunoglobulin A nephropathy after kidney transplantation

  • Yoshie HoshinoAffiliated withDepartment of Medicine, Kidney Center, Tokyo Women’s Medical University Email author 
  • , Yasutomo AbeAffiliated withDepartment of Nephrology, Okubo Hospital, Tokyo Metropolitan Health and Medical Treatment Corporation
  • , Mariko EndoAffiliated withDepartment of Nephrology, Okubo Hospital, Tokyo Metropolitan Health and Medical Treatment Corporation
  • , Sachiko WakaiAffiliated withDepartment of Nephrology, Okubo Hospital, Tokyo Metropolitan Health and Medical Treatment Corporation
  • , Hiroki ShirakawaAffiliated withDepartment of Transplantation, Okubo Hospital, Tokyo Metropolitan Health and Medical Treatment Corporation
  • , Osamu HottaAffiliated withHotta Osamu Clinic
  • , Hideki IshidaAffiliated withDepartment of Urology, Tokyo Women’s Medical University
  • , Kazunari TanabeAffiliated withDepartment of Urology, Tokyo Women’s Medical University
  • , Ken TsuchiyaAffiliated withDepartment of Medicine, Kidney Center, Tokyo Women’s Medical University
    • , Kosaku NittaAffiliated withDepartment of Medicine, Kidney Center, Tokyo Women’s Medical University

Abstract

Five cases of recurrent immunoglobulin A nephropathy (IgAN) after kidney transplantation were successfully treated by tonsillectomy and steroid pulse therapy (SPT). The clinical background and pathology in the five cases were different, but good results were obtained in all of them. In cases 1 and 2, mild recurrent IgAN developed and failed to remit after tonsillectomy alone, but a remission was achieved in both cases after SPT. In case 3, highly active recurrent IgAN with crescent lesions developed 13 years after kidney transplantation, and a remission was achieved after SPT. In case 4, renal biopsy specimens showed pathological findings of recurrent IgAN with tubulitis, and hematuria and proteinuria resolved after SPT. In case 5, the biopsy findings indicated recurrent IgAN with chronic rejection. Tonsillectomy was followed by resolution of the proteinuria, and a remission was achieved after SPT. In conclusion, SPT is effective in inducing a remission of recurrent IgAN when tonsillectomy alone fails.

Keywords

Recurrent IgA nephropathy Tonsillectomy Steroid pulse Kidney transplantation