Immune-Complex Mediated Mesangial Proliferative Glomerulonephritis with Full-House Pattern Observed During Treatment of Immune Thrombocytopenic Purpura

This study reports a rare case of immune-complex mediated mesangial proliferative glomerulonephritis (ICGN) with a full-house pattern in a 56-year-old Japanese man, observed during the treatment of immune thrombocytopenic purpura (ITP). Because of persistent complement deficiency and worsening of kidney function, he was treated with prednisolone, and his urinary findings improved markedly. However, as the complement titers were still low, mycophenolate mofetil was also prescribed, which normalized complement levels. Production of anti-platelet antibodies is considered to be involved in the etiology of ITP. Although little is known about the mechanism by which ITP causes glomerulonephritis, including ICGN, glomerular deposition of circulating immune complexes synthesized by antiplatelet antibodies may be involved. This case shows full-house nephropathy, suggesting the involvement of immune complexes, which in turn, suggested an association between ITP and glomerulonephritis.