Case Report
Copyright ©2007 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 21, 2007; 13(43): 5783-5786
Published online Nov 21, 2007. doi: 10.3748/wjg.v13.i43.5783
Association of liver cirrhosis related IgA nephropathy with portal hypertension
Georgios Kalambokis, Leonidas Christou, Dimitrios Stefanou, Evdokia Arkoumani, Epameinondas V Tsianos
Georgios Kalambokis, Leonidas Christou, Epameinondas V Tsianos, 1st Division of Internal Medicine and Hepato-gastroenterology Unit, University Hospital, Ioannina, Greece
Dimitrios Stefanou, Evdokia Arkoumani, Department of Pathology, University Hospital, Ioannina, Greece
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Epameinondas V Tsianos, Professor, Medical School of Ioannina, 45110 Ioannina, Greece.
Telephone: +30-26510-97501 Fax: +30-26510-97016
Received: June 7, 2007
Revised: September 6, 2007
Accepted: October 22, 2007
Published online: November 21, 2007

A high incidence of IgA nephropathy has been reported in patients with liver cirrhosis, though, clinically evident nephrotic syndrome is very uncommon. Impaired hepatic clearance of circulating IgA immune complexes and subsequent deposition in renal glomeruli has been considered principally in the pathogenesis of liver cirrhosis associated IgA nephropathy. Here we report on a patient with cryptogenic liver cirrhosis and splenic vein thrombosis, who presented with nephrotic syndrome. Renal biopsy showed findings consistent with IgA nephropathy. Lower endoscopy showed features of portal hypertensive colopathy. Following initiation of propranolol and anticoagulant treatment to reduce portal pressure, a gradual decrease of proteinuria and hematuria to normal range was noted. The potential pathogenetic role of portal hypertension in the development of IgA nephropathy in cirrhotic patients is discussed.

Keywords: IgA nephropathy, Nephrotic syndrome, Portal hypertension, Liver cirrhosis