Interstitial Nephritis Associated with Glomerulonephritis in a Patient with Hashimoto's Disease and Idiopathic Portal Hypertension

Hidetsugu SASAKI; Kensuke JOH; Isako OHTSUKA; Hideki OHTA; Tsutomu OHHASHI; Seiji HOASHI; Takamune TAKAHASHI; Tadaaki TOKUDA; Katsuichi KOYAMA; Yukihide ISOGAI

doi:10.2169/internalmedicine.31.641

Hidetsugu SASAKI, Kensuke JOH, Isako OHTSUKA, Hideki OHTA, Tsutomu OHHASHI, Seiji HOASHI, Takamune TAKAHASHI, Tadaaki TOKUDA, Katsuichi KOYAMA, Yukihide ISOGAI

Author information

Hidetsugu SASAKI
the Third Department of Internal Medicine, Jikei University School of Medicine
Kensuke JOH
the Department of Pathology, Jikei University School of Medicine
Isako OHTSUKA
the Third Department of Internal Medicine, Jikei University School of Medicine
Hideki OHTA
the Third Department of Internal Medicine, Jikei University School of Medicine
Tsutomu OHHASHI
the Third Department of Internal Medicine, Jikei University School of Medicine
Seiji HOASHI
the Third Department of Internal Medicine, Jikei University School of Medicine
Takamune TAKAHASHI
the Department of Pathology, Jikei University School of Medicine
Tadaaki TOKUDA
the Department of Pathology, Jikei University School of Medicine
Katsuichi KOYAMA
the Third Department of Internal Medicine, Jikei University School of Medicine
Yukihide ISOGAI
the Third Department of Internal Medicine, Jikei University School of Medicine

Keywords: nephrotic syndrome, IgA deposits, osmiophilic body, hepatic glomerulosclerosis, hypergammaglobulinemia

JOURNAL FREE ACCESS

1992 Volume 31 Issue 5 Pages 641-648

DOI https://doi.org/10.2169/internalmedicine.31.641

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Abstract

A middle-aged woman with hypothyroidism, idiopathic portal hypertension and nephrotic syndrome is presented. This unusual clinical appearance could not be explained as SLE by serological examinations. Pathohistological examinations showed "Banti's liver", Hashimoto's thyroiditis and diffuse proliferative glomerulonephritis with severe tubulo-interstitial nephritis. Immunohistochemical studies revealed IgA deposits in glomeruli. Electron microscopic study disclosed peculiar lucent areas of rare faction with osmiophilic particles in tubular basement membranes. This tubulointerstitial nephritis was considered to be related to the immunological mechanism involving thyroid gland, liver and kidney disorders. This case thus had a clinically rare combination of these three.
(Internal Medicine 31 : 641-648, 1992)

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