PMC8216373_01
Trending baseline creatinine from August 25, 2017, until November 27, 2019.
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While creatinine was normal (0.8) in May 2019 (Figure 1), it was noted to progressively worsen over the course of steroids, reaching 2.08 by November 2020 (Figure 2).
The blue arrow denotes creatinine when prednisone 1 mg/kg therapy was initiated on December 7, 2020.
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While creatinine was normal (0.8) in May 2019 (Figure 1), it was noted to progressively worsen over the course of steroids, reaching 2.08 by November 2020 (Figure 2).
Light microscopy of H&E (hematoxylin and eosin)-stained renal parenchymal biopsy at 40x magnification demonstrating a well-demarcated border between a region of dense inflammation (right) and uninvolved parenchyma (left). This demarcation is a typical finding in IgG4-related kidney disease. Arrow points to border.
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Kidney biopsy demonstrated chronic active tubulointerstitial nephritis on light microscopy, and immunofluorescence staining confirmed positive IgG4 staining (Figures 3-6).
Light microscopy of H&E (hematoxylin and eosin)-stained renal parenchymal biopsy at 100x magnification demonstrating (blue arrows) dense mononuclear tubulointerstitial infiltration. This finding is known to be seen in IgG4-related kidney disease.
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Kidney biopsy demonstrated chronic active tubulointerstitial nephritis on light microscopy, and immunofluorescence staining confirmed positive IgG4 staining (Figures 3-6).
Renal parenchymal biopsy at 100x magnification demonstrating positive IgG4 immunohistochemical staining (blue arrows), confirming IgG4-related disease.
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Kidney biopsy demonstrated chronic active tubulointerstitial nephritis on light microscopy, and immunofluorescence staining confirmed positive IgG4 staining (Figures 3-6).
Renal parenchymal biopsy at 40x magnification demonstrating positive IgG4 immunohistochemical staining (blue arrows), confirming IgG4-related disease.
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Kidney biopsy demonstrated chronic active tubulointerstitial nephritis on light microscopy, and immunofluorescence staining confirmed positive IgG4 staining (Figures 3-6).
Additional graph depicting the rise in creatinine on July 2, 2019, as well as when steroids were initiated on December 7, 2020 (blue arrow).
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Prednisone 1 mg/kg was initiated in December 2020 (Figure 7), with immediate improvement in renal function as evidenced by downtrending creatinine following initiation of high-dose steroids to 1.85 mg/kg even just a few weeks later.