Renal tubular acidosis and vasculitis associated with IgE deposits in the kidney small vessels

We report a woman with a history of allergies, polyuria, polydipsia, proteinuria, renal loss of electrolytes, renal tubular acidosis, nephrocalcinosis, and palpable purpura. A proximal defect was excluded by a normal bicarbonate reabsorption curve, and a distal tubular defect was shown because urine...

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Autores principales: Juncos, Luis I., Muio, Juan C., García, Nestór H., Ferrer, Cristina I., Romero, Marta, Sambuelli, Rubén Horacio, Beltramo, Dante Miguel
Formato: Artículo acceptedVersion
Lenguaje:Español
Publicado: 2000
Materias:
RC Medicina interna
Acceso en línea:http://pa.bibdigital.ucc.edu.ar/3919/1/A_Juncos_Muio_Garc%C3%ADa_Ferrer_Romero_Sambuelli_Beltramo.pdf
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Producción Académica Universidad Católica de Córdoba (UCCor) de Universidad Católica de Córdoba
id I38-R144-3919
record_format dspace
spelling I38-R144-39192023-06-28T14:36:35Z http://pa.bibdigital.ucc.edu.ar/3919/ Renal tubular acidosis and vasculitis associated with IgE deposits in the kidney small vessels Juncos, Luis I. Muio, Juan C. García, Nestór H. Ferrer, Cristina I. Romero, Marta Sambuelli, Rubén Horacio Beltramo, Dante Miguel RC Medicina interna We report a woman with a history of allergies, polyuria, polydipsia, proteinuria, renal loss of electrolytes, renal tubular acidosis, nephrocalcinosis, and palpable purpura. A proximal defect was excluded by a normal bicarbonate reabsorption curve, and a distal tubular defect was shown because urine pH did not decrease to less than 6.4 despite ammonium chloride- induced systemic acidosis. Moreover, furosemide failed to improve urinary acidification. Urine-to-blood PCO2 gradient was less than 14 mm Hg, although the urine bicarbonate level reached values as high as 89 mEq/L. Combining bicarbonate and neutral phosphate infusions increased the urine-to-blood PCO2 gradient to only 20 mm Hg. These subnormal PCO2 gradient values point to proton-pump dysfunction in the collecting tubule. Histological evidence of tubulointerstitial disease accompanied the tubular defects. The striking histological feature was the presence of immunoglobulin E (IgE) deposits in glomeruli, tubuli, and vessels. Concurrent with these findings, she had high serum IgE titers and CD23 levels. IgE antibodies from her serum were reactive against human renal tubuli, with binding to two regions that matched two different proteins present in cortex and medulla. One of these proteins corresponded to carbonic anhydrase II (31 kd); the second, to an unidentified protein that seems attached to cell membranes. We suggest that these IgE antibodies could have had a pathogenic role in this patient's glomerular, tubular, and small-vessel disease. 2000-12-31 application/pdf spa http://pa.bibdigital.ucc.edu.ar/3919/1/A_Juncos_Muio_Garc%C3%ADa_Ferrer_Romero_Sambuelli_Beltramo.pdf Juncos, Luis I., Muio, Juan C., García, Nestór H. ORCID: https://orcid.org/0000-0002-9057-9030 <https://orcid.org/0000-0002-9057-9030>, Ferrer, Cristina I., Romero, Marta, Sambuelli, Rubén Horacio and Beltramo, Dante Miguel ORCID: https://orcid.org/0000-0002-8198-3525 <https://orcid.org/0000-0002-8198-3525> (2000) Renal tubular acidosis and vasculitis associated with IgE deposits in the kidney small vessels. American Journal of Kidney Diseases, 35 (5). pp. 941-949. ISSN 0272-6386 https://www.scopus.com/record/display.uri?eid=2-s2.0-0034049655&origin=resultslist&sort=plf-f&src=s&nlo=&nlr=&nls=&sid=5208be89f9d87c58f9f838563e850eb9&sot=aff&sdt=cl&cluster=scopubyr%2c%222000%22%2ct&sl=189&s=AF-ID%28%22Universidad+Catolica+de+Cordoba%22+60024640%29+OR+AF-ID%28%22Universidad+Catolica+de+Cordoba++Facultad+de+Medicina%22+60015106%29+OR+AF-ID%28%22Clinica+Universitaria+Privada+Reina+Fabiola%22+60080337%29&relpos=6&citeCnt=7&searchTerm= info:eu-repo/semantics/altIdentifier/doi/10.1016/S0272-6386(00)70267-8 info:eu-repo/semantics/article info:ar-repo/semantics/artículo info:eu-repo/semantics/acceptedVersion Fil: Juncos, Luis I. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; Argentina Fil: Muio, Juan C. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; Argentina Fil: García, Nestór H. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; Argentina Fil: Ferrer, Cristina I. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; Argentina Fil: Romero, Marta. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; Argentina Fil: Sambuelli, Rubén Horacio. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; Argentina Fil: Beltramo, Dante Miguel. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; Argentina info:eu-repo/semantics/openAccess https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
institution Universidad Católica de Córdoba
institution_str I-38
repository_str R-144
collection Producción Académica Universidad Católica de Córdoba (UCCor)
language Español
orig_language_str_mv spa
topic RC Medicina interna
spellingShingle RC Medicina interna
Juncos, Luis I.
Muio, Juan C.
García, Nestór H.
Ferrer, Cristina I.
Romero, Marta
Sambuelli, Rubén Horacio
Beltramo, Dante Miguel
Renal tubular acidosis and vasculitis associated with IgE deposits in the kidney small vessels
topic_facet RC Medicina interna
description We report a woman with a history of allergies, polyuria, polydipsia, proteinuria, renal loss of electrolytes, renal tubular acidosis, nephrocalcinosis, and palpable purpura. A proximal defect was excluded by a normal bicarbonate reabsorption curve, and a distal tubular defect was shown because urine pH did not decrease to less than 6.4 despite ammonium chloride- induced systemic acidosis. Moreover, furosemide failed to improve urinary acidification. Urine-to-blood PCO2 gradient was less than 14 mm Hg, although the urine bicarbonate level reached values as high as 89 mEq/L. Combining bicarbonate and neutral phosphate infusions increased the urine-to-blood PCO2 gradient to only 20 mm Hg. These subnormal PCO2 gradient values point to proton-pump dysfunction in the collecting tubule. Histological evidence of tubulointerstitial disease accompanied the tubular defects. The striking histological feature was the presence of immunoglobulin E (IgE) deposits in glomeruli, tubuli, and vessels. Concurrent with these findings, she had high serum IgE titers and CD23 levels. IgE antibodies from her serum were reactive against human renal tubuli, with binding to two regions that matched two different proteins present in cortex and medulla. One of these proteins corresponded to carbonic anhydrase II (31 kd); the second, to an unidentified protein that seems attached to cell membranes. We suggest that these IgE antibodies could have had a pathogenic role in this patient's glomerular, tubular, and small-vessel disease.
format Artículo
Artículo
acceptedVersion
author Juncos, Luis I.
Muio, Juan C.
García, Nestór H.
Ferrer, Cristina I.
Romero, Marta
Sambuelli, Rubén Horacio
Beltramo, Dante Miguel
author_facet Juncos, Luis I.
Muio, Juan C.
García, Nestór H.
Ferrer, Cristina I.
Romero, Marta
Sambuelli, Rubén Horacio
Beltramo, Dante Miguel
author_sort Juncos, Luis I.
title Renal tubular acidosis and vasculitis associated with IgE deposits in the kidney small vessels
title_short Renal tubular acidosis and vasculitis associated with IgE deposits in the kidney small vessels
title_full Renal tubular acidosis and vasculitis associated with IgE deposits in the kidney small vessels
title_fullStr Renal tubular acidosis and vasculitis associated with IgE deposits in the kidney small vessels
title_full_unstemmed Renal tubular acidosis and vasculitis associated with IgE deposits in the kidney small vessels
title_sort renal tubular acidosis and vasculitis associated with ige deposits in the kidney small vessels
publishDate 2000
url http://pa.bibdigital.ucc.edu.ar/3919/1/A_Juncos_Muio_Garc%C3%ADa_Ferrer_Romero_Sambuelli_Beltramo.pdf
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