IgA nephropathy in a child with X-linked agammaglobulinemia: a case report

BMC Pediatr. 2024 Apr 30;24(1):291. doi: 10.1186/s12887-024-04746-7.

Abstract

Background: X-linked agammaglobulinemia (XLA) is a primary immunodeficiency disease caused by mutations in the Bruton tyrosine kinase (BTK) gene. Individuals diagnosed with XLA are at an increased risk of developing autoimmune diseases. However, renal involvement are rare in cases of XLA.

Case presentation: In this report, we discussed a specific case involving a 6-year-old boy with XLA who experienced recurrent upper respiratory tract infections since the age of one. He presented with symptoms of hematuria and proteinuria, and renal pathology confirmed the presence of immunoglobulin (Ig) A nephropathy. Treatment comprised glucocorticoids, mycophenolate mofetil, and intermittent intravenous immunoglobulin replacement therapy. Consequently, there was a remission of proteinuria and a partial improvement in hematuria.

Conclusions: In this study, we describe the first case of IgA nephropathy associated with XLA. This is an interesting phenotype found in XLA, and it provides valuable insights into the process of autoimmunity and the regulation of immune function in individuals with XLA. Based on our findings, we recommend the evaluation of immunoglobulin levels in patients diagnosed with IgA nephropathy.

Keywords: Case report; Hematuria; IgA nephropathy; Proteinuria; X-linked agammaglobulinemia.

Publication types

  • Case Reports

MeSH terms

  • Agammaglobulinemia* / complications
  • Agammaglobulinemia* / diagnosis
  • Agammaglobulinemia* / genetics
  • Child
  • Genetic Diseases, X-Linked* / complications
  • Genetic Diseases, X-Linked* / diagnosis
  • Genetic Diseases, X-Linked* / genetics
  • Glomerulonephritis, IGA* / complications
  • Glomerulonephritis, IGA* / diagnosis
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Mycophenolic Acid / therapeutic use

Substances

  • Immunoglobulins, Intravenous
  • Glucocorticoids
  • Mycophenolic Acid
  • Immunosuppressive Agents

Supplementary concepts

  • Bruton type agammaglobulinemia