Behçet's disease complicated by IgA nephropathy and interstitial nephritis

Abstract

A 46-year-old man presenting with pharyngodynia and fever was treated with non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics, without initial improvement. Conjunctival injection in the left eye appeared soon thereafter, followed by an ulcer on the glans penis 2 weeks later. On admission to our hospital, his urine was positive for protein and occult blood. Multiple folliculitis-like eruptions were noted over the lumbar region to the abdomen. Based on these mucocutaneous symptoms and a positive reaction for HLA-B51 antigen, a diagnosis of Behçet's disease was made. Renal biopsy revealed IgA nephropathy and interstitial nephritis. Urinary and other symptoms were alleviated with continued anti-inflammatory therapy. A lymphocyte stimulation test was performed to determine whether there was any relationship of the interstitial nephritis to drugs used in his treatment (ciprofloxacin, cefazolin sodium, or the NSAIDs), but results were not conclusive. Behçet's disease complicated by nephropathy, notably interstitial nephritis, is rare; this valuable experience is now reported.