Related Experiment Video
Updated: Jun 20, 2026
A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts
Published on: September 20, 2018
Membranous nephropathy secondary to very early-onset inflammatory bowel disease in a 3-year-old boy: case report
Shuhei Aoyama1, Tomohiko Yamamura2, Tomoko Horinouchi1
1Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
Abstract:
Membranous nephropathy (MN) is uncommon in children overall, but secondary MN is relatively common in younger children. Inflammatory bowel disease (IBD) can be complicated by kidney disease, but IBD complicated by MN is rarely reported. A 3-year-old boy diagnosed with very early onset IBD (VEO-IBD) a year earlier was incidentally found to have proteinuria via urine screening system. Laboratory tests revealed nephrotic syndrome with microscopic hematuria and signs of ongoing inflammation associated with IBD activity. Kidney biopsy showed mesangial cell proliferation and dense subepithelial immune complex deposits, along with negative PLA2R staining, which supported a diagnosis of secondary MN. Oral steroid therapy was initiated for its potential benefit for both nephrotic syndrome and the underlying VEO-IBD. As a result, four months later, proteinuria and hematuria had resolved, and kidney function remained stable. This is the youngest reported patient with MN associated with IBD. Routine urinalysis is suggested by this case to be useful for detecting kidney complications of IBD, including MN. Moreover, steroid therapy is likely to be useful for MN secondary to IBD. Our report suggests that potential kidney complications should also be considered in patients with VEO-IBD.
Insights
This case study highlights a 3-year-old with membranous nephropathy (MN) secondary to very early onset inflammatory bowel disease (VEO-IBD). Steroid therapy effectively treated both conditions, suggesting routine urinalysis for early detection of kidney issues in VEO-IBD patients.
Area of Science:
- Pediatric Nephrology
- Gastroenterology
- Immunology
Background:
- Membranous nephropathy (MN) is rare in children, but secondary MN is more common in younger populations.
- Inflammatory bowel disease (IBD) can lead to kidney complications, though MN associated with IBD is infrequently reported.
- Very early onset IBD (VEO-IBD) presents unique challenges in pediatric populations.
Purpose of the Study:
- To report the youngest patient with MN secondary to VEO-IBD.
- To emphasize the importance of screening for kidney complications in pediatric IBD.
- To evaluate the efficacy of steroid therapy in MN secondary to IBD.
Main Methods:
- Case report of a 3-year-old boy with VEO-IBD.
- Diagnosis of nephrotic syndrome and microscopic hematuria.
- Kidney biopsy revealing secondary MN with negative PLA2R staining.
- Treatment with oral steroids for both nephrotic syndrome and VEO-IBD.
Main Results:
- The patient presented with nephrotic syndrome and hematuria due to MN secondary to VEO-IBD.
- Kidney biopsy confirmed secondary MN.
- Following oral steroid therapy, proteinuria and hematuria resolved within four months.
- Kidney function remained stable post-treatment.
Conclusions:
- This is the youngest reported case of MN associated with IBD.
- Routine urinalysis is crucial for detecting kidney complications, including MN, in pediatric IBD patients.
- Steroid therapy appears effective for MN secondary to IBD, warranting consideration in VEO-IBD management.
Related Concept Videos
01:25Inflammatory Bowel Disease III: Crohn's Disease
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
01:20Inflammatory Bowel Disease II: Ulcerative Colitis
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:20Inflammatory Bowel Disease IV: Clinical Manifestations
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...