Discontinuing Hemodialysis through Corticosteroid Treatment in a Patient with Cryofibrinogen-associated Glomerulonephritis

Intern Med. 2024 Jul 1;63(13):1899-1905. doi: 10.2169/internalmedicine.2897-23. Epub 2023 Nov 6.

Abstract

Cryofibrinogen-associated glomerulonephritis (CryoFiGN) is rare, and its diagnosis is difficult while treatment is not established. We herein report an elderly woman with CryoFiGN who experienced recurrent purpura and nephritic features that subsequently progressed to nephrotic syndrome and required hemodialysis during the 18-month clinical course. The patient was treated with corticosteroids, which led to the discontinuation of hemodialysis. The diagnosis of CryoFiGN was based on the clinical presentation, characteristic glomerular deposits, and results of laser microdissection and liquid chromatography-tandem mass spectrometry of the glomeruli. This case highlights the potential utility of corticosteroids as a treatment option for patients with CryoFiGN, even after hemodialysis.

Keywords: cryofibrinogen; mass spectrometry; membranoproliferative glomerulonephritis; nephrotic syndrome; organized deposit.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use
  • Aged
  • Cryoglobulins
  • Female
  • Fibrinogens, Abnormal
  • Glomerulonephritis* / chemically induced
  • Glomerulonephritis* / drug therapy
  • Humans
  • Renal Dialysis*

Substances

  • cryofibrinogen
  • Adrenal Cortex Hormones
  • Fibrinogens, Abnormal
  • Cryoglobulins