When haematuria is more than warfarin: lambda-predominant IgA nephropathy
A woman in her 20s with a mechanical mitral valve replacement on long-term warfarin therapy presented with frank haematuria and acute kidney injury (AKI). The initial clinical impression was anticoagulant-related nephropathy. However, due to the persistence of urinary abnormalities, further evaluati...
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2026
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| Online Access: | http://psasir.upm.edu.my/id/eprint/123774/ https://casereports.bmj.com/lookup/doi/10.1136/bcr-2025-268864 |
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| author | Lim, Benny Chia Wue Abd Ghani, Fauzah Wah, Fuah Kar Lim, Christopher Thiam Seong |
| author_facet | Lim, Benny Chia Wue Abd Ghani, Fauzah Wah, Fuah Kar Lim, Christopher Thiam Seong |
| author_sort | Lim, Benny Chia Wue |
| building | UPM Library |
| collection | Institutional Repository |
| content_provider | Universiti Putra Malaysia |
| content_source | UPM Institutional Repository |
| continent | Asia |
| country | Malaysia |
| description | A woman in her 20s with a mechanical mitral valve replacement on long-term warfarin therapy presented with frank haematuria and acute kidney injury (AKI). The initial clinical impression was anticoagulant-related nephropathy. However, due to the persistence of urinary abnormalities, further evaluation was undertaken. Renal biopsy revealed immunoglobulin A nephropathy with lambda light chain predominance, raising concern for an underlying monoclonal gammopathy. The patient was managed conservatively with antiproteinuric therapy alone, without immunosuppression, and demonstrated favourable renal recovery. This case highlights the diagnostic importance of renal biopsy and thorough clinical reassessment in patients with haematuria and AKI, particularly in the context of anticoagulation. |
| format | Article |
| id | my.upm.eprints-123774 |
| institution | Universiti Putra Malaysia |
| publishDate | 2026 |
| record_format | eprints |
| spelling | my.upm.eprints-1237742026-04-13T00:47:34Z http://psasir.upm.edu.my/id/eprint/123774/ When haematuria is more than warfarin: lambda-predominant IgA nephropathy Lim, Benny Chia Wue Abd Ghani, Fauzah Wah, Fuah Kar Lim, Christopher Thiam Seong A woman in her 20s with a mechanical mitral valve replacement on long-term warfarin therapy presented with frank haematuria and acute kidney injury (AKI). The initial clinical impression was anticoagulant-related nephropathy. However, due to the persistence of urinary abnormalities, further evaluation was undertaken. Renal biopsy revealed immunoglobulin A nephropathy with lambda light chain predominance, raising concern for an underlying monoclonal gammopathy. The patient was managed conservatively with antiproteinuric therapy alone, without immunosuppression, and demonstrated favourable renal recovery. This case highlights the diagnostic importance of renal biopsy and thorough clinical reassessment in patients with haematuria and AKI, particularly in the context of anticoagulation. 2026-02-25 Article PeerReviewed Lim, Benny Chia Wue and Abd Ghani, Fauzah and Wah, Fuah Kar and Lim, Christopher Thiam Seong (2026) When haematuria is more than warfarin: lambda-predominant IgA nephropathy. BMJ case reports, 19 (2). ISSN 1757-790X https://casereports.bmj.com/lookup/doi/10.1136/bcr-2025-268864 Medicine (all) 10.1136/bcr-2025-268864 |
| spellingShingle | Medicine (all) Lim, Benny Chia Wue Abd Ghani, Fauzah Wah, Fuah Kar Lim, Christopher Thiam Seong When haematuria is more than warfarin: lambda-predominant IgA nephropathy |
| title | When haematuria is more than warfarin: lambda-predominant IgA nephropathy |
| title_full | When haematuria is more than warfarin: lambda-predominant IgA nephropathy |
| title_fullStr | When haematuria is more than warfarin: lambda-predominant IgA nephropathy |
| title_full_unstemmed | When haematuria is more than warfarin: lambda-predominant IgA nephropathy |
| title_short | When haematuria is more than warfarin: lambda-predominant IgA nephropathy |
| title_sort | when haematuria is more than warfarin: lambda-predominant iga nephropathy |
| topic | Medicine (all) |
| url | http://psasir.upm.edu.my/id/eprint/123774/ https://casereports.bmj.com/lookup/doi/10.1136/bcr-2025-268864 |
| url_provider | http://psasir.upm.edu.my/ |