Fibrillary glomerulonephritis (FibGN) is a rare cause of progressive renal dysfunction, often leading to dialysis within a few years. A 60-year-old woman presented with a 2 month history of right-sided retro-orbital pain and recent diplopia. Laboratory testing revealed an altered renal function with increased serum creatinine and mild proteinuria. MRI of the brain revealed the presence of a soft tissue mass on the right cavernous sinus compatible with the diagnosis of Tolosa–Hunt syndrome (THS). Renal biopsy showed a pattern compatible with fibrillary glomerulonephritis. For this reason steroid therapy was initiated at a dose of 1 mg/kg/day and adjusted according to the clinical course. Neurological symptoms regressed shortly after the beginning of therapy and renal function and proteinuria remained stable for the 3 years following the withdrawal of steroid therapy. Percutaneous renal biopsy was again performed and confirmed the previous diagnosis of FibGN in association with other glomerular-lesion-like mesangial widening, thickening of capillary walls and severe arterio-arteriolosclerosis. This case report describes what is believed to first report of the association of FibGN and THS, which both responded to steroid therapy.
Statistics from Altmetric.com
Competing interests: None.
Patient consent: Obtained.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.