Sindrome nefrótico e injuria renal aguda con microangiopatía trombótica en mujer con enfermedad celiaca. Caso clinico.

Resumen

NEPHROTIC SYNDROME AND ACUTE KIDNEY INJURY ASSOCIATED WITH CELIAC DISEASE. REPORT OF ONE CASE.

Celiac disease may be associated with other autoimmune diseases and exceptionally with glomerulopathies and nephrotic syndrome. Associations have been reported with IgA nephropathy, membranoproliferative glomerulonephritis, membranous glomerulopathy and minimal change disease.  We report  a 63 years old woman who simultaneously presented with massive nephrotic syndrome (proteinuria 46 g/day) and cachexia due to a malabsorption syndrome secondary to celiac disease. The course of her diseases was complicated with cardiomyopathy due to severe malnutrition, septic shock, acute kidney injury that required dialysis for seven weeks and severe hypertension.  A renal biopsy showed a membranoproliferative pattern of injury secondary to a thrombotic microangiopathy and diffuse podocyte damage. Four years later, the patient was in good general health, the glomerular filtration rate was 30 ml/min/1.73m² and there was non-nephrotic proteinuria.