IgM nephropathy complicated by cerebral venous sinus thrombosis: a case study

Area of Science:

• Nephrology
• Immunopathology

Background:

• IgM nephropathy is a rare kidney disease presenting with varied clinical symptoms, often leading to nephrotic syndrome.
• Histopathology reveals mesangial hypercellularity with immunoglobulin M (IgM) and complement deposition, but can range from normal glomeruli to focal and segmental glomerulosclerosis.

Observation:

• A 23-year-old male presented with nephrotic syndrome, initially diagnosed as minimal change disease based on renal biopsy.
• Despite initial remission with prednisone, the patient experienced multiple relapses and steroid dependence, necessitating a repeat biopsy.
• The second biopsy indicated IgM nephropathy, and a subsequent relapse was complicated by cerebral venous sinus thrombosis.

Findings:

• The case demonstrates that IgM nephropathy can mimic minimal change disease, requiring re-evaluation upon relapse or steroid resistance.
• Cerebral venous sinus thrombosis is a rare but serious complication associated with severe nephrotic syndrome, as observed in this patient.

Implications:

• This case underscores the importance of including IgM nephropathy in the differential diagnosis for nephrotic syndrome.
• It highlights the significant risk of thromboembolic events, such as cerebral venous sinus thrombosis, in patients with severe nephrosis, necessitating vigilant monitoring and management.