18 August 2023
: Case report 
IgG4-Related Membranous Nephropathy with Acute Nephrotic Syndrome During Successful Steroid Maintenance Treatment for Type 1 Autoimmune Pancreatitis
Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Educational Purpose (only if useful for a systematic review or synthesis), Rare coexistence of disease or pathology
Hiroshi Ito12ABCDEF, Kenji Ashida
12ABCDEF*, Mutsuyuki Demiya1BDE, Seiichi Motomura1BCDEF, Ayako Nagayama1BCDEF, Saori Kubo 3ABCDEF, Utako Ueda3ABCDEF, Kei Fukami3CDEF, Masatoshi Nomura1ACDE, Tomoyuki Akashi2BDE
DOI: 10.12659/AJCR.940707
Am J Case Rep 2023; 24:e940707
Table 1. Laboratory data on admission.
| Parameter | Value | Reference range | Parameter | Value | Reference range |
|---|---|---|---|---|---|
| WBC, cells/μL | 7900 | 3,300–8,600 | C-reactive protein, mg/dL | 0.08 | 0–0.14 |
| Neutrophil, % | 73.3 | 40–74 | Anti-nuclear Ab, times | Negative | |
| Eosinophil, % | 3.2 | 0–6 | Rheumatoid factor, U/mL | Negative | |
| Basophil, % | 0.8 | 0–1 | PR3-ANCA, U/mL | <1.0 | <3.5 |
| Lymphocyte, % | 16.5 | 18–59 | MPO-ANCA, U/mL | <1.0 | <3.5 |
| Monocyte, % | 6.2 | 0–8 | IgA, mg/dL | 170 | 93–393 |
| RBC count, cells×104/μL | 449 | 435–555 | IgM, mg/dL | 55 | 33–183 |
| Hemoglobin, g/dL | 14.0 | 13.7–16.8 | 3–319 | ||
| Hematocrit, % | 44.8 | 40.7–50.1 | IgG, mg/dL | 1380 | 861–1747 |
| 83.6–98.2 | 11–121 | ||||
| Platelet count, cells×10/μL | 21.5 | 15.8–34.8 | HBs antigen | Negative | |
| HCV Ab | Negative | ||||
| 6.6–8.1 | C, mg/dL | 104 | 73–183 | ||
| 4.1–5.1 | C, mg/dL | 30 | 11–31 | ||
| AST, IU/L | 30 | 13–30 | Anti-GAD Ab, U/mL | <5.0 | 0–5.0 |
| ALT, IU/L | 23 | 10–30 | |||
| Amylase, IU/L | 99 | 50–200 | PT/INR | 0.91 | 0.85–1.15 |
| Alkaline phosphatase, IU/L | 88 | 38–113 | APTT, second | 29.3 | 24–39 |
| Blood urea nitrogen, mg/dL | 17 | 8–20 | D-dimer, μg/mL | 0.7 | 0–1.0 |
| Creatinine, mg/dL | 0.71 | 0.65–1.07 | |||
| Sodium, mmol/L | 141 | 138–145 | <0.15 | ||
| Potassium, mmol/L | 4.1 | 3.6–4.8 | RBC count/HPF | <1 | 0–4 |
| Chloride, mmol/L | 107 | 101–108 | NAG, IU/L | 2.9 | 0–11.5 |
| 8.8–10.1 | NGAL, ng/mL | <10.0 | 0–30.5 | ||
| Phosphorus, mg/dL | 2.9 | 2.7–4.6 | β2MG, μg/L | <50 | 0–230 |
| 142–219 | |||||
| FPG, mg/dL | 108 | 73–109 | |||
| 4.9–6.0 | |||||
| 0.8–2.5 | |||||
| Abnormal values are presented in bold. Ab – antibody; ALT – alanine aminotransferase; APTT – activated partial thromboplastin time; AST – aspartate aminotransaminase; β2MG – beta-2 microglobulin; CPR – C-peptide immunoreactivity; FPG – fasting plasma glucose; GAD – glutamic acid decarboxylase; HbA1c – hemoglobin A1C; HBs – hepatitis B surface; HCV – hepatitis C virus; HPF – high-power field; IgA – immunoglobulin A; IgE – immunoglobulin E; IgM – immunoglobulin M; IgG – immunoglobulin G; MPO-ANCA – myeloperoxidase-anti-neutrophil cytoplasmic antibody; NAG – N-Acetyl-β-d-glucosaminidase; NGAL – neutrophil gelatinase-associated lipocalin; PR3-ANCA – proteinase 3-anti-neutrophil cytoplasmic antibody; PT/INR – prothrombin time/international normalized ratio; RBC – red blood cell; TSH – thyroid-stimulating hormone; WBC – white blood cell. | |||||