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A case of paraneoplastic IgA nephropathy with glomerular capillary IgA and galactose-deficient IgA1 deposition

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Abstract

Paraneoplastic IgA nephropathy (IgAN) is an underrecognized condition in which malignancy manifests as symptoms of IgAN, and it remains controversial regarding their mechanistic relation between IgAN and malignancy. Herein, we report a case of a 68-year-old Japanese man with glottic cancer who developed nephrotic syndrome as a clinical manifestation of IgAN. Renal biopsy revealed diffuse proliferative glomerulonephritis with glomerular capillary IgA deposition that is a rare subtype of IgAN. After complete remission of the glottic cancer by irradiation, proteinuria and hematuria disappeared. Based on his clinical course, we diagnosed paraneoplastic IgAN. Therefore, we should consider the possibility that IgAN with glomerular capillary IgA deposition might be paraneoplastic glomerulopathy especially before initiating immunosuppressive therapy. The patient thereafter developed prostate cancer and hepatocellular cancer, but IgAN did not recur. The association of IgAN specifically with the glottic cancer in this triple-cancer patient may suggest a potential link between IgAN and mucosal cancer. Because galactose-deficient IgA1 (Gd-IgA1) was observed in the similar pattern as IgA, Gd-IgA1 also may play an important role in the pathogenesis of paraneoplastic IgAN.

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Authors and Affiliations

  1. Division of Anti-Ageing Medicine, Center for Molecular Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan

    Erika Isogai, Yoshitaka Iwazu & Makoto Kuro-o

  2. Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan

    Yoshitaka Iwazu, Tetsu Akimoto & Daisuke Nagata

  3. Department of Integrative Pathology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan

    Toshiro Niki

Authors
  1. Erika Isogai
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  2. Yoshitaka Iwazu
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  3. Tetsu Akimoto
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  4. Makoto Kuro-o
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  5. Toshiro Niki
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  6. Daisuke Nagata
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Correspondence to Yoshitaka Iwazu.

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Isogai, E., Iwazu, Y., Akimoto, T. et al. A case of paraneoplastic IgA nephropathy with glomerular capillary IgA and galactose-deficient IgA1 deposition. CEN Case Rep 13, 104–109 (2024). https://doi.org/10.1007/s13730-023-00807-5

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  • DOI: https://doi.org/10.1007/s13730-023-00807-5

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