ArticleOpen medicine (Warsaw, Poland)2026
Glucocorticoids combined with rituximab treatment for IgG4-related tubulointerstitial nephritis with diabetic nephropathy: a case report.
Article in Open medicine (Warsaw, Poland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: IgG4-related disease is a chronic immune-mediated disorder featuring elevated serum IgG4 levels and the tissue infiltration of IgG4-positive plasma cells. Kidney involvement in IgG4-related disease, known as IgG4-related kidney disease, most commonly manifests as tubulointerstitial nephritis. Case Presentation: A 55-year-old male presented with acute kidney injury (creatinine=816 μmol/L), severe anemia, lymphadenopathy, and high IgG4 levels (13.89 g/L). Renal MRI and Chest CT showed diffuse renal abnormalities and mediastinal lymphadenopathy. Renal biopsy confirmed IgG4-related tubulointerstitial nephritis, complicated by IgA nephropathy and diabetic nephropathy. Initial glucocorticoid treatment was prescribed followed by 1.8 g rituximab consolidation therapy. Over 32 months follow-up, the patient's renal function significantly improved (creatinine 215 μmol/L) and his serum IgG4 levels normalized (0.89 g/L). Conclusions: This success of this case suggests that combination therapy may be a reasonable option in selected cases, and underscores the importance of an early diagnosis, pathological confirmation, and standardized immunosuppressive therapy for improving the outcomes in IgG4-related kidney disease.
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