Kaposi Sarcoma in Patient with Membranous Glomerulonephropathy during Corticosteroid Therapy / 대한신장학회잡지

ABSTRACT

Membranous glomerulonephropathy is a common cause of nephrotic syndrome in adults. Kaposi sarcoma is a well-known entity with distinct clinical forms such as nodular cutaneous lesions, generalized lymphadenopathy and visceral involvement. Incidence of Kaposi sarcoma is greater in patients with immunosuppression, particularly those having undergone renal transplantation, but also in patients with other underlying disorders treated with immunosuppressive therapy, notably, corticosteroids. We present a case of Kaposi sarcoma in patient with membranous glomerulopathy during corticosteroid therapy. A 49- year-old man was admitted with a complain of facial and leg edema, 5-kg weight gain for 1 month, and foamy urine. Kidney biopsy showed membranous glomerulopathy. We started corticosteroid therapy to the patient. Two month later, his 24 hr urinary protein was decreased to 2.1 g/day. But, the well defined, various-sized, purple-colored papules and plaque appeared on the both hands and feet. He underwent skin biopsy, which revealed abnormally proliferated and dilated vessels, vascular slits, spindle-shaped cells and extravasated erythrocytes in the dermis. The findings were in accordance with Kaposi sarcoma. So he received cryotherapy with discontinuing corticosteroid. Four months after cryotherapy, skin lesions were cleared leaving slight hypopigmentation and amount of proteinuria was preserved without definite aggravation.