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- Atsuhiko Suenaga, Naoki Sawa, Daisuke Ikuma, Yuki Oba, Akinari Sekine, Masayuki Yamanouchi, Eiko Hasegawa, Hiroki Mizuno, Tatsuya Suwabe, Kei Kono, Yukako Shintani-Domoto, Keiichi Kinowaki, Kenichi Ohashi, Yoshiyuki Suzuki, Motoaki Miyazono, Tamiko Takemura, Yutaka Yamaguchi, and Yoshifumi Ubara.
- Department of Nephrology and Rheumatology, Toranomon Hospital Kajigaya, Japan.
- Intern. Med. 2023 Sep 15; 62 (18): 269927062699-2706.
AbstractWe performed 3 kidney biopsies in a 71-year-old man. At the first biopsy, we made the diagnosis of immunoglobulin G4 (IgG4)-related interstitial nephritis characterized by the simultaneous presence of IgG4-positive plasma cells and characteristic fibrosis with a bird's-eye pattern. At the second biopsy, rather than finding fibrosis as a post-inflammatory scar, we noted that steroid treatment had caused the simultaneous disappearance of IgG4-positive plasma cells and fibrosis and had restored the normal tubular structure. The third biopsy showed the recurrence of the disease with inflammatory cells accompanied by fibrosis. These findings suggest that IgG4-positive plasma cells and fibrosis occur simultaneously.
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