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Journal of the Korean Society of Pediatric Nephrology 2008;12(2): 233-238. doi: https://doi.org/10.3339/jkspn.2008.12.2.233
거대세포바이러스와 연관된 IgA 신병증을 Deflazacort와 정맥 면역글로불린으로 치료한 1례
윤서희, 안승희, 남궁미경
1연세대학교 원주의과대학 소아과학교실
2연세대학교 원주의과대학 소아과학교실
3연세대학교 원주의과대학 소아과학교실
Treatment of Cytomegalovirus-associated IgA Nephropathy by Deflazacort and Intravenous Immunoglobulin
Seo-Hee Yoon, Seung-Hee Ahn, Mee-Kyung NamGoong
1Pediatric Department, Yonsei University, Wonju College of Medicine
2Pediatric Department, Yonsei University, Wonju College of Medicine
3Pediatric Department, Yonsei University, Wonju College of Medicine
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ABSTRACT
It has been suspected that various infections, including cytomegalovirus(CMV) infection, are associated with IgA nephropathy. In case of CMV infection, ganciclovir is known to be a treatment of choice for severe CMV infection in general. But ganciclovir has a lot of severe toxicity, so children with normal immunity are seldom treated by ganciclovir when CMV infection is suspected. On the other hand, intravenous immunoglobulin can also be used to treat CMV infection. We report a case of CMV-associated IgA nephrophaty, who was treated with deflazacort and Intravenous immunoglobulin therapy. An 11 years old boy suffered from gross hematuria for 3 days. He had proteinuria, thrombocytopenia(104,000/$mm^3$), antiplatelet antibody(+), impaired renal function and low serum albumin. His CMV serology was CMV-IgM/IgG(+/-) and urine CMV-PCR was positive. The renal histological findings revealed IgA nephropathy, WHO class II. His proteinuria persisted despite of deflazacort therapy(2.5 mg/kg/day). Later, intravenous immunoglobulin(1 g/kg) was administered twice. In two years, he showed no gross and microscopic hematuria, and his laboratory findings were also normalized.
Key words: IgA nephropathy | Cytomegalovirus | Intravenous immunoglobulin therapy | Children
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