Nephritis

Proliferative glomerulonephritis is a rare complication of IBD. There are few reports about it in the literature and most of them regard UC [45-52]. The pathogenic mechanism is not clear but there is evidence about deposition in the glomeruli of the immune complex secondary to intestinal antigens which are released from the inflamed bowel and bound to circulating antibodies [46, 53-54]. For this reason glomerulonephritis has been noticed more frequently in correlation with active inflammation of the bowel [48, 55].

Clinically, patients usually present with oliguria and analysis shows proteinuria, urinary sediment, elevated serum creatinine and a picture of severe renal disease. Immunofluorescence microscopy can demonstrate glomerular deposition of immunoglob-ulin and/or complement [46, 56]. Steroids are usually sufficient for improving renal function [46,49,57], but they should be followed by resection of the affected bowel [55].

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