Skip to main content

Advertisement

SpringerLink
Log in

Renal granuloma and immunoglobulin M-complex glomerulonephritis: a case of common variable immunodeficiency?

  • Brief Report
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Common variable immunodeficiency (CVID) is characterized by reduced serum immunoglobulin levels and recurrent bacterial infections. Granulomatous infiltrations are occasionally found in the lymphoid or solid organs of affected patients, but renal involvement is rare. We present a case of possible CVID with interstitial noncaseating granuloma and immunoglobulin (IgM)-complex glomerulonephritis with a membranoproliferative pattern and with a favorable response to corticosteroids, intravenously administered immunoglobulins (IVIGs) and rituximab. CVID must be included in the differential diagnosis of renal granuloma and should be differentiated from sarcoidosis to ensure appropriate therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. Hermaszewski RA, Webster AD (1993) Primary hypogammaglobulinaemia: a survey of clinical manifestations and complications. Q J Med 86:31–42

    CAS  PubMed  Google Scholar 

  2. Cunningham-Rundles C (2001) Common variable immunodeficiency. Curr Allergy Asthma Rep 1:421–429

    Article  CAS  Google Scholar 

  3. Morimoto Y, Routes JM (2005) Granulomatous disease in common variable immunodeficiency. Curr Allergy Asthma Rep 5:370–375

    Article  CAS  Google Scholar 

  4. Fakhouri F, Robino C, Lemaire M, Droz D, Noel LH, Knebelmann B, Lesavre P (2001) Granulomatous renal disease in a patient with common variable immunodeficiency. Am J Kidney Dis 38:E7

    Article  CAS  Google Scholar 

  5. Stigant C, Sapir D, Sweet J, Downey G, Bargman JM (2002) A unique renal lesion in common variable immunodeficiency. Clin Nephrol 57:74–79

    Article  CAS  Google Scholar 

  6. Meyer A, Lachmann HJ, Webster AD, Burns A, Thway K (2005) Hypercalcemia in a patient with common variable immunodeficiency and renal granulomas. Am J Kidney Dis 45:e90–e93

    Article  Google Scholar 

  7. Conley ME, Notarangelo LD, Etzioni A (1999) Diagnostic criteria for primary immunodeficiencies. Representing PAGID (Pan-American Group for Immunodeficiency) and ESID (European Society for Immunodeficiencies). Clin Immunol 93:190–197

    Article  CAS  Google Scholar 

  8. Bijol V, Mendez GP, Nose V, Rennke HG (2006) Granulomatous interstitial nephritis: a clinicopathologic study of 46 cases from a single institution. Int J Surg Pathol 14:57–63

    Article  Google Scholar 

  9. Viero RM, Cavallo T (1995) Granulomatous interstitial nephritis. Hum Pathol 26:1347–1353

    Article  CAS  Google Scholar 

  10. Mignon F, Mery JP, Mougenot B, Ronco P, Roland J, Morel-Maroger L (1984) Granulomatous interstitial nephritis. Adv Nephrol Necker Hosp 13:219–245

    CAS  PubMed  Google Scholar 

  11. Fasano MB, Sullivan KE, Sarpong SB, Wood RA, Jones SM, Johns CJ, Lederman HM, Bykowsky MJ, Greene JM, Winkelstein JA (1996) Sarcoidosis and common variable immunodeficiency. Report of 8 cases and review of the literature. Medicine (Baltimore) 75:251–261

    Article  CAS  Google Scholar 

  12. Kanamori H, Ota M, Takeoka H, Osafune K, Yonezu S, Fukatsu A, Kanatsu K (2006) IgM-immune complex glomerulonephritis associated with sarcoidosis. Clin Exp Nephrol 10:68–73

    Article  Google Scholar 

  13. Ohkubo H, Nagai M, Hojo S, Daikuhara H, Takahara J, Itoh T, Harada A (1993) Membranoproliferative glomerulonephritis in a patient with common variable hypogammaglobulinemia. J Rheumatol 20:918–919

    CAS  PubMed  Google Scholar 

  14. Knight AK, Cunningham-Rundles C (2006) Inflammatory and autoimmune complications of common variable immune deficiency. Autoimmun Rev 5:156–159

    Article  CAS  Google Scholar 

  15. Wakim M, Shah A, Arndt PA, Garratty G, Weinberg K, Hofstra T, Church J (2004) Successful anti-CD20 monoclonal antibody treatment of severe autoimmune hemolytic anemia due to warm reactive IgM autoantibody in a child with common variable immunodeficiency. Am J Hematol 76:152–155

    Article  Google Scholar 

  16. Carbone J, Escudero A, Mayayo M, Ballesteros M, Perez-Corral A, Sanchez-Ramon S, Sarmiento E, Micheloud D, Fernandez-Cruz E (2005) Partial response to anti-CD20 monoclonal antibody treatment of severe immune thrombocytopenic purpura in a patient with common variable immunodeficiency. Ann N Y Acad Sci 1051:666–671

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Nephrology, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, 3175 Chemin de la Côte Sainte-Catherine, Montreal, Quebec, H3T 1C5, Canada

    Geneviève Benoit & Anne-Laure Lapeyraque

  2. Department of Pathology, CHU Sainte-Justine, Université de Montréal, Montreal, Quebec, Canada

    Hervé Sartelet

  3. Division of Rheumatology, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montreal, Quebec, Canada

    Claire Saint-Cyr

  4. Department of Microbiology and Immunology, CHU Sainte-Justine, Université de Montréal, Montreal, Quebec, Canada

    Françoise Le Deist

  5. Division of Immunology, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montreal, Quebec, Canada

    Élie Haddad

Authors
  1. Geneviève Benoit
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anne-Laure Lapeyraque
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hervé Sartelet
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Claire Saint-Cyr
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Françoise Le Deist
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Élie Haddad
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anne-Laure Lapeyraque.

Additional information

The authors declare that they had no financial support.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Benoit, G., Lapeyraque, AL., Sartelet, H. et al. Renal granuloma and immunoglobulin M-complex glomerulonephritis: a case of common variable immunodeficiency?. Pediatr Nephrol 24, 601–604 (2009). https://doi.org/10.1007/s00467-008-0958-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-008-0958-z

Keywords

Search

Navigation