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MODERN RHEUMATOLOGY Vol.14 No.2

>MR14-2

Marked hypocomplementemia and tubulointerstitial nephritis in a male patient with SjOgrens syndrome
Naoichiro Yukawa1 , Norioki Tsuboi1, Sonosuke Yukawa1, Haeru Hayashi1, Taisuke Arai1, Haruo Abe1, Koichiro Tahara1, Hirofumi Takanashi1 and Tohru Hayashi1
(1) Third Department of Internal Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
Received: 22 November 2002 Accepted: 22 August 2003

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Abstract

 We report a case of marked hypocomplementemia and tubulointerstitial nephritis associated with SjOgrens syndrome (SS) in a male patient. Renal biopsy revealed tubulointerstitial nephritis but did not identify specific immune deposits of the tubulointerstitium. After steroid therapy, the renal failure and hypocomplementemia diminished. Hypocomplementemia without cryoglobulinemia is not commonly observed in SS patients, and hypocomplementemic tubulointerstitial nephritis was strongly suspected. Hypocomplementemic tubulointerstitial nephritis is rare; only one case has been described in the literature. In our case and the previous case, the patients were elderly men, and they had some similar clinical characteristics. Idiopathic hypocomplementemic tubulointerstitial nephritis resembling our case has been reported. These facts suggest that hypocomplementemic tubulointerstitial nephritis may occur in patients with SS, and such cases may not be as rare as once thought because it might be appropriate to include them in the category of idiopathic cases. Such a syndrome should be included in the differential diagnosis of hypocomplementemia.
 
Key words
Hypergammaglobulinemia - Hypocomplementemia - Male - SjOgrens syndrome (SS) - Tubulointerstitial nephritis (TIN)
 
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