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Nephrotic Syndrome Associated with Buerger's Disease
Nahomi Yamaguchi1, Akihiro Fukuda1, Norihiro Furutera1
1Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Japan.
Internal Medicine (Tokyo, Japan)
|September 2, 2021
Summary
Buerger's disease can cause nephrotic syndrome and kidney dysfunction through renal microinfarctions. Angiotensin-converting enzyme inhibitor therapy improved hypertension and proteinuria in a patient with Buerger's disease and focal segmental glomerulosclerosis.
Area of Science:
- Nephrology
- Vascular Medicine
- Pathology
Background:
- Buerger's disease is a rare condition affecting blood vessels, typically in the legs and feet.
- Nephrotic syndrome is a kidney disorder characterized by protein in the urine, low blood protein levels, and swelling.
Observation:
- A 43-year-old woman with Buerger's disease presented with nephrotic syndrome, renal dysfunction, and mild hypertension.
- Kidney biopsy revealed focal segmental glomerulosclerosis (FSGS) without secondary causes or history of chronic hypertension.
- Renal scintigraphy showed a small focal renal infarction.
Findings:
- The findings suggest FSGS was caused by renal microinfarction linked to Buerger's disease.
- Treatment with angiotensin-converting enzyme inhibitors improved hypertension and reduced proteinuria.
- Renal ischemia from vasoconstriction in Buerger's disease may lead to glomerular hyperfiltration and subsequent FSGS.
Implications:
- This case highlights a potential link between Buerger's disease and FSGS.
- Early diagnosis and management of Buerger's disease may prevent or mitigate renal complications.
- ACE inhibitor therapy shows promise in managing hypertension and proteinuria in such cases.
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