間質に泡沫細胞の浸潤を認めたIgA腎症の2例

Abstract

This report describes two cases with IgA nephropathy exhibiting numerous foam cells in renal interstitium. Case 1 : A 53-year-old man who was diagnosed as having IgA nephropathy at the age of 40 was admitted again for rebiopsy. His renal function was gradually deteriorated for 13 years and amounts of urinary protein increased from 0.8 to 2.4 g/day. However, neither nephrotic-range proteinuria nor hyperlipidemia was observed during the clinical course. The second renal biopsy showed moderate mesangial prolifera- tion with a small crescent and numerous intersititial foam cells. In comparison with the first biopsy, glomerular lesions got worse and interstitial foam cells appeared. Case 2 : A 50-year-old woman was admitted to our hospital because of chance proteinuria and hematuria. A 24 h urine collection included 1.2 g of protein. Her renal function was normal and hyperlipidemia was not present. The renal biopsy revealed mild mesangial prolifera- tion with mesangial IgA deposits. Immunohisto-chemical study demonstrated that in both cases interstitial foam cells were positive for CD 68, which is a marker of macrophage. Infiltration of foam cells in the interstitium is extremely rare in non-nephrotic patients with IgA nephropathy. We discuss the significance and possible pathogenesis of interstitial foam cells with literatures.