[IgG4-related kidney disease. Diagnosis and treatment]

Nihon Rinsho Meneki Gakkai Kaishi. 2015;38(1):8-16. doi: 10.2177/jsci.38.8.
[Article in Japanese]

Abstract

IgG4-related disease (IgG4-RD) is a systemic inflammatory disorder that can affect most organs/tissues like sarcoidosis. The kidney is one of the most frequently affected organs. While tubulointerstitial nephritis (TIN) with characteristic imaging findings is the representative lesion of IgG4-related kidney disease (IgG4-RKD), a variety of glomerular lesions, particularly membranous nephropathy, sometimes overlap on TIN. Clinically, either decreased renal function and/or characteristic imaging findings such as multiple low-density lesions on contrast-enhanced computed tomography are typical presenting features. Histologically, plasma cell (PC)-rich TIN accompanied by characteristic fibrosis called storiform fibrosis with dense IgG4-positive PC infiltration is a typical finding. Although a swift response to corticosteroid is a very important feature of IgG4-RKD, in cases with moderately to severely decreased renal function before therapy, only partial recovery of renal function is obtained. This review provides a comprehensive overview of IgG4-RKD from the clinical, laboratory, imaging, and histological aspects and also addresses some of the therapeutic issues concerning it.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Aged
  • Female
  • Fibrosis
  • Glucocorticoids / administration & dosage
  • Humans
  • Immunoglobulin G / immunology*
  • Kidney / pathology
  • Kidney Diseases / diagnosis*
  • Kidney Diseases / immunology
  • Kidney Diseases / pathology
  • Kidney Diseases / therapy*
  • Male
  • Nephritis, Interstitial / diagnosis
  • Nephritis, Interstitial / immunology
  • Nephritis, Interstitial / therapy
  • Plasma Cells / immunology
  • Plasma Cells / pathology
  • Prednisolone / administration & dosage
  • Prognosis
  • Tomography, X-Ray Computed

Substances

  • Glucocorticoids
  • Immunoglobulin G
  • Prednisolone