• Internal medicine · Nov 2023

    Case Reports

    Remission Induction of IgG4-related Membranous Nephropathy with Multitarget Therapy.

    • Yoshitaka Furuto, Hirotsugu Hashimoto, Akio Namikawa, Teppei Morikawa, and Yuko Shibuya.
    • Department of Hypertension and Nephrology, NTT Medical Center Tokyo, Japan.
    • Intern. Med. 2023 Nov 1; 62 (21): 317531813175-3181.

    AbstractIgG4-related membranous nephropathy (MN) is often refractory to glucocorticoid (GC) therapy, and treatment remains unclear. We herein report a 67-year-old Japanese man with IgG4-related MN and tubulointerstitial nephritis. A post-gastroscopy antibody test revealed Helicobacter pylori infection. After eradication, his proteinuria decreased indefinitely. We started prednisolone (30 mg/day), long-term GCs, and immunosuppressant therapy. However, remission proved challenging to achieve, with persistent proteinuria present at 1.0-2.0 g/gCr. We performed multitarget therapy for refractory IgG4-related MN, achieving proteinuria remission (<0.3 g/gCr). Multitarget therapy with low-dose GCs can resolve refractory IgG4-related MN through remission induction of proteinuria and minimize the risks associated with GC therapy.

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