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      IgA Nephropathy in a Patient with Polycythemia vera

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          IgA nephropathy (IgAN) is one of the most frequent forms of glomerulonephritis (GN). However, its association with polycythemia vera (PV) has rarely been described. We report a case of IgAN combined with PV. The patient was a 46-year-old male with chronic renal failure, heavy proteinuria and erythrocytosis. He also presented hypertension and hematuria as well as splenomegaly, high arterial oxygen saturation and elevated leukocyte alkaline phosphatase activity. Possible causes of secondary erythrocytosis were ruled out. The renal biopsy revealed mesangial proliferative GN with predominant IgA deposition in mesangium. He was diagnosed as having IgAN and PV concomitantly. After administration of hydroxyurea, enalapril and felodipine, blood cell count and blood pressure normalized, while azotemia persisted. There was also a partial remission of the heavy proteinuria. We describe a case of IgAN associated with PV, and possible pathophysiologic relationships between two diseases are discussed with review of the literature.

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          Secondary Polycythemia Associated with Idiopathic Membranous Nephropathy

          A 58-year-old male patient had secondary polycythemia associated with idiopathic nephrotic syndrome. The renal biopsy revealed membranous nephropathy, and the bone marrow biopsy disclosed hypercellular marrow with mild panhyperplasia. The concentration of serum erythropoietin was 8.5 mU/ml. The erythrocytosis was characterized by an increased red cell volume (40.2 ml/kg) and normal arterial oxygen saturation. There were no associated lesions that could induce secondary polycythemia, except the biopsy-proven membranous nephropathy. He was treated with prednisolone and cyclophosphamide, and the nephrotic syndrome was partially remitted after 6 weeks. With partial remission of nephrotic syndrome, the erythrocytosis was resolved. This case illustrates the rarely reported association of the nephrotic syndrome and erythrocytosis, and the resolution of erythrocytosis with improvement of nephrotic syndrome.
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            Erythrocytosis associated with the nephrotic syndrome

             R. Sonneborn (1977)

              Author and article information

              Am J Nephrol
              American Journal of Nephrology
              S. Karger AG
              August 2002
              02 August 2002
              : 22
              : 4
              : 397-401
              Departments of aDiagnostic Pathology and bInternal Medicine, Asan KangNung Hospital and cDepartment of Internal Medicine, Asan KangNung Hospital, University of Ulsan College of Medicine, KangNung City, South Korea
              65236 Am J Nephrol 2002;22:397–401
              © 2002 S. Karger AG, Basel

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              Page count
              Figures: 2, Tables: 1, References: 21, Pages: 5
              Self URI (application/pdf): https://www.karger.com/Article/Pdf/65236
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