Rheumatology International

, Volume 30, Issue 6, pp 821–825

Diffuse proliferative glomerulonephritis associated with dermatomyositis with nephrotic syndrome

  • Qibing Xie
  • Yi Liu
  • Gang Liu
  • Nanping Yang
  • Geng Yin
Case Report

Abstract

We described a 44-year-old man developing dermatomyositis (DM) and nephrotic syndrome (NS). Renal biopsy revealed diffuse proliferative glomerulonephritis (DPGN) with depositions of immunoglobulin and complements. A combination therapy of steroid and cyclophosphamide (CTX) was found very effective for the patient. Chronic glomerulonephritis is rare in DM. In our review of related literature, membranous glomerulonephritis (MN) is the main type of glomerular lesion, another type is mesangial proliferative glomerulonephritis (mesPGN). Here we reported a case of DM associated with DPGN developing NS, which was not found in existing literature. Although glomerulonephritis is uncommon in patients with DM, renal pathology is not as simplex as previously thought, and treatment with steroid or/and cytotoxic drugs is favorable for prognosis.

Keywords

Dermatomyositis Glomerulonephritis Nephrotic syndrome Treatment 

References

  1. 1.
    Bohan A, Peter JB (1975) Polymyositis and dermatomyositis. N Engl J Med 292:344–347, 403–407Google Scholar
  2. 2.
    Yen TH, Lai PC, Chen CC, Hsueh S, Huang JY (2005) Renal involvement in patients with polymyositis and dermatomyositis. Int J Clin Pract 59:188–193. doi:10.1111/j.1742-1241.2004.00248.x CrossRefPubMedGoogle Scholar
  3. 3.
    Fukui H, Kimura T, Nakabayashi K, Nagasawa T (1976) A case report of dermatomyositis associated with membranous glomerulonephritis induced by renal tubular antigen. Nippon Jinzo Gakkai Shi 18:523–533PubMedGoogle Scholar
  4. 4.
    Moriyama T, Uruta Y, Yamaguchi H, Fukuzaki M, Uchida Y, Yasumoto Y, Yamashita W, Harada R, Ohsaki K, Nakajima A (1989) A case of immune complex type glomerulonephritis associated with dermatomyositis. Nippon Naika Gakkai Zasshi 78:994–995PubMedGoogle Scholar
  5. 5.
    Makino H, Hirata K, Matsuda M, Amano T, Ota Z (1994) Membranous nephropathy developing during the course of dermatomyositis. J Rheum 21:1377–1378PubMedGoogle Scholar
  6. 6.
    Picco P, Gattorno M, Barbano GC, Trivelli A, Pistoria V, Buoncompagni A (1997) Mesangial glomerulonephritis and transient SLE manifestations in an adolescent with dermatomyositis. Lupus 6:72–73CrossRefPubMedGoogle Scholar
  7. 7.
    Akashi Y, Inoh M, Gamo N, Kinashi M, Ohbayashi S, Miyake H, Kurata N (2002) Dermatomyositis associated with membranous nephropathy in a 43-year-old female. Am J Nephrol 22:385–388. doi:10.1159/000065233 CrossRefPubMedGoogle Scholar
  8. 8.
    Yen TH, Huang JY, Chen CY (2003) Unexpected IgA nephropathy during the treatment of a young woman with idiopathic dermatomyositis: case report and review of the literature. J Nephrol 16:148–153PubMedGoogle Scholar
  9. 9.
    Soylu A, Kavukçu S, Türkmen M, Saroglu S (2001) Dermatomyositis with membranous nephropathy. Turk J Pediatr 43:143–145PubMedGoogle Scholar
  10. 10.
    Dyck RF, Katz A, Gordon DA, Johnson M, Shainhouse Z, Cardella CJ, Bear RA (1979) Glomerulonephritis associated with polymyositis. J Rheumatol 6:336–344PubMedGoogle Scholar
  11. 11.
    Hosoda T, Toshida S, Mimori T, Toguchi T, Inada S, Tomii M, Yamagata H, Akizuki M, Abe T (1981) Polymyositis associated with interstitial pulmonary fibrosis and glomerulonephritis. A report of two autopsy cases. Ryumachi 21(Suppl):S183–S188Google Scholar
  12. 12.
    Hara I, Kurata N, Hyoudou I, Tamao H (1991) A case of polymyositis complicated with membranous nephritis. Nippon Naika Gakkai Zasshi 80:108–109PubMedGoogle Scholar
  13. 13.
    Tsunemi M, Ishihara E, Tsumura K, Shoji S, Sugimura T, Nishizawa Y, Morii H (1993) A case of crescentic glomerulonephritis associated with polymyositis. Nephron 64:488–489. doi:10.1159/000187383 CrossRefPubMedGoogle Scholar
  14. 14.
    Yasunobu T, Hiroko K, Kojiro S, Kimito K, Akihiro Y, Hiroshi U, Jan S, Shoji T, Yashikata M, Kazuhiko Y (2007) Polymyositis associated with focal mesangial proliferative glomerulonephritis with depositions of immune complexes. Clin Rheumatol 26:792–796. doi:10.1007/s10067-006-0200-y CrossRefGoogle Scholar
  15. 15.
    Moutsopoulos H, Fye KH (1975) Lipoid nephrosis and focal glomerulosclerosis in a patient with polymyositis. Lancet 1:1039. doi:10.1016/S0140-6736(75)91990-X CrossRefPubMedGoogle Scholar
  16. 16.
    Kilani B, Amari L, Houmane H, Ben CT (2005) Association of systemic lupus erythematosus and dermatomyositis. Tunis Med 83:230–232PubMedGoogle Scholar
  17. 17.
    David HJ (2001) Inflammatory muscle disease. Curr Opin Neurol 14:591–596. doi:10.1097/00019052-200110000-00007 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Qibing Xie
    • 1
  • Yi Liu
    • 1
  • Gang Liu
    • 1
  • Nanping Yang
    • 1
  • Geng Yin
    • 1
  1. 1.Department of Rheumatology and ImmunologyWest China Hospital of Sichuan UniversityChengduChina

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