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논문분류	춘계학술대회 초록집
제목	IgA-Dominant Postinfectious Glomerulonephritis after Acupuncture
저자	Lee Arim
출판정보	2026; 2026(1):
키워드	IgA-dominant PIGN, acupuncture , kidney transplant recipients., hemodialysis, Escherichia coli.
초록	Objectives: IgA-dominant postinfectious glomerulonephritis (IgA-dominant PIGN) is a distinct form of glomerulonephritis that arises in the context of infection and is characterized by predominant IgA deposition on immunofluorescence. This entity primarily affects adults, particularly elderly patients, and is frequently reported in individuals with underlying conditions such as diabetes mellitus. Here, we present a case of IgA-dominant PIGN occurring in a kidney transplant recipient following multiple acupuncture sessions performed for the management of lower back pain. This report underscores the potential for post-procedural infections to trigger IgA-dominant glomerular injury in immunocompromised patients. Methods: A 73-year-old woman, under routine follow-up after kidney transplantation, presented with chills, fever, and generalized myalgia. On admission, laboratory evaluation revealed a serum creatinine of 2.9 mg/dL and an estimated glomerular filtration rate (eGFR) of 15 mL/min/1.73 m², indicating acute kidney injury. Notably, she reported receiving repeated acupuncture treatments targeting her lower back and the transplant kidney area for persistent back pain over the preceding two months. This temporal association raised concern for a post-procedural infectious trigger contributing to renal dysfunction. Results: During hospitalization, persistent elevation of serum creatinine and blood urea nitrogen, along with oliguria, was observed. A renal biopsy was subsequently performed, which demonstrated post-infectious glomerulonephritis with crescents (Banff scores: i2, g2, ci1, ct1, ptc2, IF/TA1, ti2). Blood cultures grew Escherichia coli. The patient subsequently underwent transurethral catheterization (TCC) and initiation of hemodialysis. Conclusion: During follow-up, the patient’s urine output is 1,000–1,500 mL/day, with serum creatinine of 5.0 mg/dL and eGFR of 10 mL/min/1.73 m². She is currently receiving hemodialysis twice weekly. This case suggests that repeated acupuncture near a transplanted kidney may act as a trigger for infection, leading to IgA-dominant postinfectious glomerulonephritis (IgA-dominant PIGN) and subsequent renal function decline. It underscores the importance of patient education regarding infection prevention, particularly in immunocompromised individuals such as kidney transplant recipients.
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