{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T14:37:35Z","timestamp":1768833455382,"version":"3.49.0"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,20]],"date-time":"2024-04-20T00:00:00Z","timestamp":1713571200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,20]],"date-time":"2024-04-20T00:00:00Z","timestamp":1713571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Immunoglobulin G4-related disease is an inflammatory disease affecting multiple organs including the kidney. Immunoglobulin G4-related kidney disease most commonly manifests as a tubulointerstitial nephritis and is associated with glomerular disease in a proportion of cases. Membranous nephropathy is the most frequent glomerular lesion. Herein, we report the first documented case of immunoglobulin G4-related disease presenting with nephrotic syndrome owing to minimal change disease.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 67-year-old South Asian male presented to our service with systemic upset and leg swelling. He had heavy proteinuria (urine protein:creatinine ratio 1042\u00a0mg\/mmol) and was hypoalbuminemic (17\u00a0g\/L) and hypercholersterolemic (9.3\u00a0mmol\/L), consistent with the nephrotic syndrome. His serum creatinine was 140\u00a0\u03bcmol\/L, and he was hypocomplementemic (C3 0.59\u00a0g\/L, C4\u2009&lt;\u20090.02\u00a0g\/L) with raised immunoglobulin G4 subclass levels (5.29\u00a0g\/L). Kidney biopsy demonstrated minimal change disease alongside a plasma-cell-rich tubulointerstitial nephritis with strong positive staining for immunoglobulin G4. A diagnosis of minimal change disease in the setting of immunoglobulin G4-related disease was made. He was commenced on oral prednisolone at 60\u00a0mg daily but suffered infectious complications, including necrotizing fasciitis within 3\u00a0weeks of starting treatment, ultimately resulting in his death 52\u00a0days after initial presentation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This case highlights the potential for immunoglobulin G4-related disease to be associated with a spectrum of glomerular pathologies including minimal change disease. It adds to the differential diagnosis of secondary causes of minimal change disease, and moreover, aids as an important reminder of the potential complications of high-dose steroids used in its treatment.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-024-04494-3","type":"journal-article","created":{"date-parts":[[2024,4,20]],"date-time":"2024-04-20T00:01:37Z","timestamp":1713571297000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Immunoglobulin G4-related disease presenting with nephrotic syndrome due to minimal change disease: a case report"],"prefix":"10.1186","volume":"18","author":[{"given":"Amy","family":"Needleman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Sheaff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth J.","family":"Pepper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7543-2041","authenticated-orcid":false,"given":"Rhys D. R.","family":"Evans","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,4,20]]},"reference":[{"key":"4494_CR1","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1097\/MNH.0b013e32835265ac","volume":"21","author":"LD Cornell","year":"2012","unstructured":"Cornell LD. IgG4-related kidney disease. Curr Opin Nephrol Hypertens. 2012;21:279\u201388.","journal-title":"Curr Opin Nephrol Hypertens"},{"key":"4494_CR2","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1038\/ki.2013.393","volume":"85","author":"T Saeki","year":"2014","unstructured":"Saeki T, Kawano M. IgG4-related kidney disease. Kidney Int. 2014;85:251\u20137.","journal-title":"Kidney Int"},{"key":"4494_CR3","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.ekir.2018.08.011","volume":"4","author":"RDR Evans","year":"2019","unstructured":"Evans RDR, et\u00a0al. Clinical manifestations and long-term outcomes of IgG4-related kidney and retroperitoneal involvement in a United Kingdom IgG4-related disease cohort. Kidney Int Rep. 2019;4:48\u201358.","journal-title":"Kidney Int Rep"},{"key":"4494_CR4","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1007\/s10157-011-0521-2","volume":"15","author":"M Kawano","year":"2011","unstructured":"Kawano M, et\u00a0al. Proposal for diagnostic criteria for IgG4-related kidney disease. Clin Exp Nephrol. 2011;15:615\u201326.","journal-title":"Clin Exp Nephrol"},{"key":"4494_CR5","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1186\/s12882-021-02477-w","volume":"22","author":"M Tian","year":"2021","unstructured":"Tian M, et\u00a0al. Co-occurrence of IgA nephropathy and IgG4-Tubulointersitial nephritis effectively treated with tacrolimus: a case report. BMC Nephrol. 2021;22:279.","journal-title":"BMC Nephrol"},{"key":"4494_CR6","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.1681\/ASN.2011010062","volume":"22","author":"Y Raissian","year":"2011","unstructured":"Raissian Y, et\u00a0al. Diagnosis of IgG4-related tubulointerstitial nephritis. J Am Soc Nephrol JASN. 2011;22:1343\u201352.","journal-title":"J Am Soc Nephrol JASN"},{"key":"4494_CR7","doi-asserted-by":"publisher","first-page":"332","DOI":"10.2215\/CJN.05000516","volume":"12","author":"M Vivarelli","year":"2017","unstructured":"Vivarelli M, Massella L, Ruggiero B, Emma F. Minimal change disease. Clin J Am Soc Nephrol CJASN. 2017;12:332\u201345.","journal-title":"Clin J Am Soc Nephrol CJASN"},{"key":"4494_CR8","doi-asserted-by":"publisher","first-page":"712","DOI":"10.3109\/14397595.2015.1019958","volume":"27","author":"K Yamada","year":"2017","unstructured":"Yamada K, et\u00a0al. A case developing minimal change disease during the course of IgG4-related disease. Mod Rheumatol. 2017;27:712\u20135.","journal-title":"Mod Rheumatol"},{"key":"4494_CR9","doi-asserted-by":"publisher","first-page":"1016","DOI":"10.1038\/ki.2010.271","volume":"78","author":"T Saeki","year":"2010","unstructured":"Saeki T, et\u00a0al. Clinicopathological characteristics of patients with IgG4-related tubulointerstitial nephritis. Kidney Int. 2010;78:1016\u201323.","journal-title":"Kidney Int"},{"key":"4494_CR10","doi-asserted-by":"publisher","first-page":"826","DOI":"10.1038\/ki.2013.191","volume":"84","author":"T Saeki","year":"2013","unstructured":"Saeki T, et\u00a0al. The clinical course of patients with IgG4-related kidney disease. Kidney Int. 2013;84:826\u201333.","journal-title":"Kidney Int"},{"key":"4494_CR11","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1097\/MD.0b013e318289610f","volume":"92","author":"A Khosroshahi","year":"2013","unstructured":"Khosroshahi A, et\u00a0al. Rethinking Ormond\u2019s disease: \u2018idiopathic\u2019 retroperitoneal fibrosis in the era of IgG4-related disease. Medicine (Baltimore). 2013;92:82\u201391.","journal-title":"Medicine (Baltimore)"},{"key":"4494_CR12","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/609795","volume":"2012","author":"M Kawano","year":"2012","unstructured":"Kawano M, et\u00a0al. Immunohistochemical characteristics of IgG4-related tubulointerstitial nephritis: detailed analysis of 20 Japanese cases. Int J Rheumatol. 2012;2012: 609795.","journal-title":"Int J Rheumatol"},{"key":"4494_CR13","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.2215\/CJN.0000000000000193","volume":"18","author":"A Chaba","year":"2023","unstructured":"Chaba A, et\u00a0al. Clinical and prognostic factors in patients with IgG4-related kidney disease. Clin J Am Soc Nephrol CJASN. 2023;18:1031\u201340.","journal-title":"Clin J Am Soc Nephrol CJASN"},{"key":"4494_CR14","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1016\/j.ebiom.2015.03.003","volume":"2","author":"S Buelli","year":"2015","unstructured":"Buelli S, et\u00a0al. Mitochondrial-dependent autoimmunity in membranous nephropathy of IgG4-related disease. EBioMedicine. 2015;2:456\u201366.","journal-title":"EBioMedicine"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04494-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-024-04494-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04494-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,20]],"date-time":"2024-04-20T00:01:50Z","timestamp":1713571310000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-024-04494-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,20]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4494"],"URL":"https:\/\/doi.org\/10.1186\/s13256-024-04494-3","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,20]]},"assertion":[{"value":"7 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 April 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient\u2019s next-of-kin for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"192"}}