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Published on: September 22, 2019
Familial cases of glomerulonephritis complicating Crohn's disease
L Kallel1, N Nijaa, L Ben Fatma
1Department of Gastroenterology A, Rabta Hospital Tunis, Tunisia.
Insights
This study highlights a rare familial occurrence of glomerulonephritis in Crohn's disease patients, suggesting a potential genetic link for extra-intestinal manifestations. Further research into genetic factors influencing these manifestations is warranted.
Area of Science:
- Nephrology
- Gastroenterology
- Genetics
Background:
- Renal involvement, especially glomerulonephritis, is uncommon in Crohn's disease (CD).
- The genetic and environmental influences on CD's extra-intestinal manifestations (EIMs) are not well understood.
- Familial clustering of EIMs may indicate a genetic predisposition.
Purpose of the Study:
- To report a familial case of glomerulonephritis in mother and daughter with Crohn's disease.
- To explore the potential genetic influence on extra-intestinal manifestations in Crohn's disease.
Main Methods:
- Case report of a 38-year-old woman and her 59-year-old mother with Crohn's disease.
- Clinical evaluation including peripheral edema, nephrotic syndrome, renal function tests, and abdominal sonography.
- Renal biopsy in one patient revealing membranous glomerulonephritis.
Main Results:
- Both patients presented with nephrotic syndrome and peripheral edema during their Crohn's disease course.
- One patient developed renal failure, while the other maintained preserved renal function.
- Renal biopsy confirmed membranous glomerulonephritis in one patient.
Conclusions:
- This familial case suggests a possible genetic link between Crohn's disease and glomerulonephritis.
- Genetic factors may play a significant role in the development of extra-intestinal manifestations in Crohn's disease.
- Further investigation into the genetic underpinnings of CD-associated glomerulonephritis is recommended.
Abstract:
A part from nephrolithiasis, renal involvement is rare in the course of Crohn's disease, particularly glomerulonephritis. On the other hand, while onset of Crohn's disease is strongly influenced by environmental and genetic factors, little is known regarding influence of these factors on extra intestinal manifestations. We report a familial case of glomerulonephritis that occurred in a 38-year old woman and her mother, 59 years old with a 7-year and a 37 year history of stenosing ileocolonic disease, respectively. Both of them developed peripheral oedema with nephrotic syndrome during the course of their Crohn's disease while they had no intestinal symptoms and were not receiving any maintenance therapy. Renal function was conserved in the former while the latter developed renal failure and had already small size kidneys on abdominal sonography. Thus, renal biopsy had been performed only in the former patient and had showed membranous glomerulonephritis. Investigations showed no other underlying disease than Crohn's disease. Through this report we emphasis possible genetic influence on extra intestinal manifestations, particularly glomerulonephritis, in Crohn's disease patients.
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