Primary membranous nephropathy with concomitant IgA nephropathy

Reza Khorsan, Ramy M. Hanna, Khalid Ameen, Farid Arman, Niloofar Nobakht, Huma Hasnain, Ashley Hyunh, Anjay Rastogi

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Membranous nephropathy (MN), an autoimmune glomerulonephritis which can occur in primary and secondary forms, is one of the most common inflammatory glomerulopathies in elderly patients. The pathophysiology of the primary form is generally due to circulating immunoglobulin (IgG4) antibodies which often target phospholipase A2 receptors (anti-PLA2R) and Thrombospondin Type 1 Domain containing 7A (anti THSD7A). IgA nephropathy is one of the most common autoimmune glomerular diseases in the world and presents with a spectrum of disease ranging from asymptomatic mild hematuria and proteinuria to rapidly progressive crescentic glomerulonephritis. We present a rare case of concomitant IgA and primary MN in a single patient treated successfully with renin-angiotensin-aldosterone blockade, corticosteroids, and calcineurin inhibitors. The peak proteinuria was near 7.5-8 g protein/g creatinine by various measures. Serum creatinine remained normal, and anti-PLA2R was detectable and decreased with successful treatment. Clinicians should be aware of the possibility of two glomerular disorders in patients with glomerulonephritis and atypical presentations for any single disorder.

Original languageEnglish
Pages (from-to)531-536
Number of pages6
JournalSaudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia.
Volume30
Issue number2
DOIs
StatePublished - 1 Mar 2019
Externally publishedYes

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