Korean J Med > Volume 74(5); 2008 > Article
The Korean Journal of Medicine 2008;74(5):546-550.
Membranous glomerulonephritis associated with pancreatic tuberculosis
Jeong Hwa Lee, Jun Ho Song, Ye Ree Park, Jin Young Kim, Chul Woo Yang, Yong Soo Kim, Byung Kee Bang
경희대학교 의과대학 순환기내과학교실
증례 : 췌장 결핵에 동반된 막성 신병증 1예
이정화, 송준호, 박예리, 김진영, 양철우, 김용수, 방병기
Abstract
A 51-year old man presented with generalized edema for 10 days. He was admitted to the hospital for a renal biopsy, and a pancreatic mass was incidentally detected by ultrasonography. The renal biopsy was consistent with membranous glomerulonephritis and the pancreas biopsy revealed chronic granulomatous inflammation with multinucleated giant cells, which was suggestive of tuberculosis of the pancreas. The patient was initially treated with a steroid and anti-tuberculosis drugs, but the proteinuria in the nephrotic range persisted throughout the 3-month follow-up. With the presumed diagnosis of tuberculosis-induced membranous nephropathy, immunosuppressant therapy was stopped and anti-tuberculosis drugs were administered for 31 months. With anti-tuberculous treatment, the proteinuria was reduced from 22 g/day to 0.57 g/day. A follow-up abdominal CT revealed a marked reduction in the size of the pancreatic mass. This finding suggests that the membranous nephropathy in our case was related to the pancreatic tuberculosis rather than it being related to primary nephrotic syndrome.
Key Words: Pancreatic tuberculosis; Membranous glomerulonephritis; Nephrotic syndrome


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