Case report on pathogenetic link between gluten and IgA nephropathy
Abstract Background A relationship between IgA nephropathy (IgAN) and celiac disease (CD) has been reported. We show the pathogenetic link for the first time. Case presentation A 39-year-old man with cystic fibrosis (CF) and CF-related diabetes started to present gross hematuria, back pain and heada...
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| Format: | Article |
| Language: | English |
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BMC
2018-05-01
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| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12876-018-0792-0 |
| _version_ | 1818214071315464192 |
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| author | Stefano Costa Giovanni Currò Salvatore Pellegrino Maria Cristina Lucanto Giovanni Tuccari Antonio Ieni Giuseppina Visalli Giuseppe Magazzù Domenico Santoro |
| author_facet | Stefano Costa Giovanni Currò Salvatore Pellegrino Maria Cristina Lucanto Giovanni Tuccari Antonio Ieni Giuseppina Visalli Giuseppe Magazzù Domenico Santoro |
| author_sort | Stefano Costa |
| collection | DOAJ |
| description | Abstract Background A relationship between IgA nephropathy (IgAN) and celiac disease (CD) has been reported. We show the pathogenetic link for the first time. Case presentation A 39-year-old man with cystic fibrosis (CF) and CF-related diabetes started to present gross hematuria, back pain and headache. At admission, laboratory analysis showed increase in serum creatinine of 1.5 mg/dl, together with hematuria and mild proteinuria (1 g/24 h). He underwent a renal biopsy to investigate the cause of hematuria and renal failure. Biopsy was consistent with IgAN. In view of patient reported dyspepsia, an upper gastrointestinal endoscopy with duodenal biopsies was undertaken and was normal. We looked for mucosal deposits of tTG-2 in the duodenum and the renal mesangium. tTG-2 deposits were found both in the duodenum and in renal biopsies, where they topographically replicated mesangial IgA deposits. After one year on a continued gluten containing diet, the patient developed a Marsh 2 type duodenal pathology. Conclusions Our findings suggest a connection between CD and IgAN in terms of an immune-mediated gluten-induced pathogenesis even in the absence of villous atrophy and serum celiac autoantibodies. |
| first_indexed | 2024-12-12T06:14:21Z |
| format | Article |
| id | doaj.art-f0746d1340d5444985ddda298a92e67e |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-12T06:14:21Z |
| publishDate | 2018-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-f0746d1340d5444985ddda298a92e67e2022-12-22T00:35:04ZengBMCBMC Gastroenterology1471-230X2018-05-011811510.1186/s12876-018-0792-0Case report on pathogenetic link between gluten and IgA nephropathyStefano Costa0Giovanni Currò1Salvatore Pellegrino2Maria Cristina Lucanto3Giovanni Tuccari4Antonio Ieni5Giuseppina Visalli6Giuseppe Magazzù7Domenico Santoro8Celiac Regional Centre, Pediatric Gastroenterology and Cystic Fibrosis Unit, University of MessinaCeliac Regional Centre, Pediatric Gastroenterology and Cystic Fibrosis Unit, University of MessinaCeliac Regional Centre, Pediatric Gastroenterology and Cystic Fibrosis Unit, University of MessinaCeliac Regional Centre, Pediatric Gastroenterology and Cystic Fibrosis Unit, University of MessinaDepartment of Human Pathology of Adult and Evolutive Age ‘Gaetano Barresi’, University of MessinaDepartment of Human Pathology of Adult and Evolutive Age ‘Gaetano Barresi’, University of MessinaDepartment of Biomedical and Dental Sciences and Morphofunctional Imaging, University of MessinaCeliac Regional Centre, Pediatric Gastroenterology and Cystic Fibrosis Unit, University of MessinaDepartment of Clinical and Experimental Medicine, Unit of Nephrology and Dialysis, University of MessinaAbstract Background A relationship between IgA nephropathy (IgAN) and celiac disease (CD) has been reported. We show the pathogenetic link for the first time. Case presentation A 39-year-old man with cystic fibrosis (CF) and CF-related diabetes started to present gross hematuria, back pain and headache. At admission, laboratory analysis showed increase in serum creatinine of 1.5 mg/dl, together with hematuria and mild proteinuria (1 g/24 h). He underwent a renal biopsy to investigate the cause of hematuria and renal failure. Biopsy was consistent with IgAN. In view of patient reported dyspepsia, an upper gastrointestinal endoscopy with duodenal biopsies was undertaken and was normal. We looked for mucosal deposits of tTG-2 in the duodenum and the renal mesangium. tTG-2 deposits were found both in the duodenum and in renal biopsies, where they topographically replicated mesangial IgA deposits. After one year on a continued gluten containing diet, the patient developed a Marsh 2 type duodenal pathology. Conclusions Our findings suggest a connection between CD and IgAN in terms of an immune-mediated gluten-induced pathogenesis even in the absence of villous atrophy and serum celiac autoantibodies.http://link.springer.com/article/10.1186/s12876-018-0792-0IGA nephropathyCeliac diseaseTissue transglutaminaseImmunofluorescence techniquePathogenesis |
| spellingShingle | Stefano Costa Giovanni Currò Salvatore Pellegrino Maria Cristina Lucanto Giovanni Tuccari Antonio Ieni Giuseppina Visalli Giuseppe Magazzù Domenico Santoro Case report on pathogenetic link between gluten and IgA nephropathy BMC Gastroenterology IGA nephropathy Celiac disease Tissue transglutaminase Immunofluorescence technique Pathogenesis |
| title | Case report on pathogenetic link between gluten and IgA nephropathy |
| title_full | Case report on pathogenetic link between gluten and IgA nephropathy |
| title_fullStr | Case report on pathogenetic link between gluten and IgA nephropathy |
| title_full_unstemmed | Case report on pathogenetic link between gluten and IgA nephropathy |
| title_short | Case report on pathogenetic link between gluten and IgA nephropathy |
| title_sort | case report on pathogenetic link between gluten and iga nephropathy |
| topic | IGA nephropathy Celiac disease Tissue transglutaminase Immunofluorescence technique Pathogenesis |
| url | http://link.springer.com/article/10.1186/s12876-018-0792-0 |
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