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Membranous glomerulonephritis in association with ulcerative colitis
R K Dhiman1, U Poddar, B C Sharma
1Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow.
Summary
Glomerulonephritis is rarely associated with ulcerative colitis. This case shows membranous glomerulonephritis causing proteinuria in an ulcerative colitis patient, which improved after colectomy.
Area of Science:
- Nephrology
- Gastroenterology
- Immunology
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- Glomerulonephritis, particularly membranous glomerulonephritis (MGN), is an uncommon extraintestinal manifestation of UC.
- The pathogenesis linking UC and MGN remains incompletely understood.
Observation:
- A patient with established ulcerative colitis presented with nephrotic-range proteinuria.
- Renal biopsy confirmed the diagnosis of membranous glomerulonephritis.
- The patient's proteinuria significantly improved following a colectomy procedure.
Findings:
- Colectomy led to a substantial reduction in proteinuria in a patient with UC-associated MGN.
- This suggests a potential link between colonic inflammation and the development or progression of MGN.
- Surgical intervention may be a therapeutic option for this rare complication.
Implications:
- This case highlights the importance of considering renal involvement in patients with ulcerative colitis, especially those with proteinuria.
- It suggests that controlling or removing the source of inflammation (the colon) may positively impact associated glomerulonephritis.
- Further research is warranted to elucidate the mechanisms and explore colectomy as a treatment strategy for UC-related MGN.