Abstract
A 55 year-old previously healthy man admitted to the hospital because of pretibial edema. Laboratory examination on admission showed marked proteinuria and low albuminemia, and a diagnosis of nephrotic syndrome was made. A first renal biopsy was performed on Febr. 1, 1982. Because the specimen showed circumferential crescentic formation in about 60% of the observed glomeruli, the cocktail therapy using prednisolone, cyclophosphamide, dipyridamole, heparin, warfarin and urokinase was done for about two months. After this therapy, his urinary protein excretion decreased and elevated serum IgA value also decreased. Creatinin clearance increased. The second renal biopsy was performed on May. 21, 1982 after the end of cocktail therapy. On immunofluorescent study, IgA deposited in the mesangial area of the glomeruli and partially extended along the capillary walls. Other IgG and complements were all negative. Therefore, a diagnosis of crescentic IgA nephritis was made retrospectively. On light microscopic study, the specimen showed the decrease of crescentic formation from 60% to 20%, suggested that crescentic glomerulonephritis have a tendency to resolute through the cocktail therapy. It was considered that the cocktail therapy might be one of the effective therapy to improve the prognosis of crescentic IgA nephritis.
