Empagliflozin–Associated Armanni-Ebstein Lesions in IgA Nephropathy

A 26-year-old woman with 3-year Nutcracker phenomenon initially had intermittent mild proteinuria (urine protein-to-creatinine ratio <0.2 g/g) and microscopic hematuria, untreated as asymptomatic. Eight months ago, urine protein-to-creatinine ratio was worsened (to 0.50–1.086 g/g). Nondiabetic (normal fasting glucose and hemoglobin A1c; negative urine glucose), she received empagliflozin, 10 mg/d, reducing urine protein-to-creatinine ratio to 0.25 g/g, but with persistent urine glucose (+++ – ++++).