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Intern Med. 2019 Jun 7. doi: 10.2169/internalmedicine.2640-19. [Epub ahead of print]

A Case of Primary IgA Vasculitis with Nephritis in a Patient with Rheumatoid Arthritis Diagnosed by Anti-galactose-deficient IgA1 Immunostaining.

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Department of Nephrology, Tokyo Women's Medical University, Japan.


Renal disease is a common complication of rheumatoid arthritis (RA) and can occur secondary to RA or be induced by therapeutic agents. Recently, glomerular deposition of galactose-deficient IgA1 (Gd-IgA1) was identified as a feature of primary IgA vasculitis with nephritis (IgA-VN). We herein report a case of IgA-VN in an RA patient whose disease activity was controlled by treatment with etanercept. To distinguish between primary IgA-VN and secondary IgA-VN caused by RA or etanercept, we performed immunostaining of renal biopsy sections with the Gd-IgA1-specific antibody KM55. Positive KM55 staining confirmed the diagnosis of primary IgA-VN in a patient with RA.


IgA vasculitis with nephritis; anti-galactose-deficient IgA1 antibody; nephrotic syndrome; rheumatoid arthritis

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