IGA NEPHROPATHY ASSOCIATED WITH HYPER IGANEMIA, PSORIASIS OR PUSTULOSIS AND OSSIFICATION

This is a report on two cases of IgA nephropathy associated with psori asis vulgaris, having hyper IgAnemia (above 500 mg/dl) and ossificatio n. Case 1 is a 47-year-old woman with a 7-year history of psoriasis vu lgaris, and case 2 is a 57-year-old man with a 17-year history of this disease. IgA was 526 and 1,356 mg/dl, respectively. HLA analysis show ed A2, A26 (10), Bw62 (15), Bw46, Cw3, DRw12 (5), and DRw8 in the form er, and A2, A11, B13, Bw46, Cw11, DR4, and DRw8 in the latter. Renal b iopsy specimens disclosed mild mesangial proliferative glomerulonephri tis and moderate mesangial proliferative glomerulonephritis with predo minant IgA deposition in mesangial area, respectively A bone-scintigra phy revealed a high uptake of radioisotopes in the left shoulder, the vertebra, the sacroiliac joint, both sides of the knees and ankles, an d the sterno-cost-clavicular area. An X-ray study showed ossification of the posterior longitudinal ligament (OPLL) in the former, and ankyl osing spinal hyperostosis (ASH) in the latter. A review of the literat ure discloses three other case reports of hyper IgAnemia, IgA nephropa thy, psoriasis or pustulosis, and ossification. The alertness of derma tologists, orthopedic surgeons, rheumatologists, and general practitio ners will be required to attain to a more frequent diagnosis of the ab ove combination.