Korean J Nephrol.  2002 Nov;21(6):1006-1010.

A Case of Ig A Nephropathy Associated with Polycythemia Vera

• Kim JH
• Choi P
• Jung YS
• Chang SH
• Eo WK
• Chun BK
• Rim H

Abstract

Secondary polycythemia is occasionally associated with renal diseases such as renal tumors, cysts, hydronephrosis, renal transplantation, renal artery stenosis and Bartter's syndrome and is rarely associated with nephrotic syndrome, nephrosclerosis, pyelonephritis, chronic gromerulonephritis and membranous nephropathy. The association of polycythemia vera and Immunoglobulin A nephropathy (IgAN) is well not known, and there are only a few isolated reports presenting the concomitance of polycythemia vera and IgAN. We report one patient with concomitant polycythemia vera and Ig A nephropathy. A 53 year-old male visited our hospital because of elevated hemoglobin level. Blood value of hemoglobin was 22.1 g/dL. Isotopic blood studies with radioactive chromium (51Cr)-labelled red blood cells revealed a total blood volume of 90 mL/kg and total red cell volume of 61.8 mL/kg. The concentration of serum erythropoietin measured by radioimmunoassay was 14.29 mIU/mL (normal 10.2-25.2 mIU/mL). Bone marrow aspirate revealed hypercellularity and panmyelosis, characteristically. Renal biopsy specimens showed moderate mesangioproliferative lesions with mesangial IgA and C3 deposition. Treatment with phlebotomy, hydroxyurea and oral prednisolone (1 mg/kg/day) was done. There was no decrease of urinary protein following treatment of phlebotomy and hydroxyurea. But urinary protein decreased and hemoglobin level normalized following combination treatment of phlebotomy, hydroxyurea and oral prednisolone.

Keyword

IgA nephropathy; Polycythemia vera; Nephrotic syndrome

MeSH Terms

Bartter Syndrome
Biopsy
Blood Volume
Bone Marrow
Cell Size
Chromium
Erythrocytes
Erythropoietin
Glomerulonephritis, IGA
Glomerulonephritis, Membranous
Humans
Hydronephrosis
Hydroxyurea
Immunoglobulin A
Kidney Transplantation
Male
Middle Aged
Nephrosclerosis
Nephrotic Syndrome
Phlebotomy
Polycythemia Vera*
Polycythemia*
Prednisolone
Pyelonephritis
Radioimmunoassay
Renal Artery Obstruction
Chromium
Erythropoietin
Hydroxyurea
Immunoglobulin A
Prednisolone