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Updated: Feb 8, 2026
11:18
Direct Drug Delivery to Kidney via the Renal Artery
Published on: April 17, 2021
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Renal-limited Cryoglobulinemic Vasculitis: Two Case Reports.
Naoya Toriu1, Naoki Sawa1, Masahiko Oguro1
1Nephrology Center, Toranomon Hospital, Japan.
Internal Medicine (Tokyo, Japan)
|July 3, 2018
Summary
Cryoglobulinemic vasculitis (CV) can present as a kidney-limited disease. This study highlights two cases of severe nephrotic proteinuria due to renal-limited CV, suggesting it as a distinct subset.
Area of Science:
- Nephrology
- Immunology
- Pathology
Background:
- Cryoglobulinemic vasculitis (CV) typically involves systemic symptoms like kidney disease, arthritis, and neuropathy.
- Understanding the spectrum of CV presentation is crucial for accurate diagnosis and management.
Observation:
- Two patients presented with severe nephrotic range proteinuria as the primary manifestation of CV.
- No significant extrarenal symptoms were observed during their clinical course.
- Renal biopsies showed membranoproliferative glomerulonephritis (MPGN) with IgM deposits, but lacked definitive microtubule structures.
Findings:
- Standard immunosuppressive therapy and plasmapheresis provided only temporary and partial relief.
- Biological therapy with rituximab (RTX) was ineffective in these cases.
- The histological findings, while typical for MPGN in CV, lacked specific ultrastructural markers.
Implications:
- Renal-limited CV should be considered a distinct clinical subset of essential CV.
- This presentation challenges the traditional view of CV requiring prominent extrarenal manifestations.
- Further research is needed to optimize treatment strategies for renal-limited CV, as conventional and biological therapies showed limited efficacy.
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