Coexistence of ANCA-associated glomerulonephritis and anti-phospholipase A2 receptor antibody-positive membranous nephropathy
| العنوان: | Coexistence of ANCA-associated glomerulonephritis and anti-phospholipase A2 receptor antibody-positive membranous nephropathy |
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| المؤلفون: | Edward Y. Skolnik, Sheena Surindran, Nazia Hasan, Rivka Ayalon, David J. Salant, Laura Barisoni, Laurence H. Beck, Lada Beara-Lasic |
| المصدر: | Clinical Kidney Journal |
| بيانات النشر: | Oxford University Press, 2012. |
| سنة النشر: | 2012 |
| مصطلحات موضوعية: | Transplantation, Kidney, Pathology, medicine.medical_specialty, Proteinuria, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Autoantibody, membranous nephropathy, Glomerulonephritis, ANCA vasculitis, medicine.disease, Clinical Reports, medicine.anatomical_structure, Membranous nephropathy, Nephrology, Proteinase 3, medicine, Clinical Cases, antiphospholipase, Plasmapheresis, Renal biopsy, medicine.symptom, business |
| الوصف: | Antibodies to myeloperoxidase (MPO) and proteinase 3 (PR3) have been demonstrated to mediate anti-neutrophil cytoplasmic antibody (ANCA)-associated disease. For membranous nephropathy, antibodies to the podocyte-expressed phospholipase A2 receptor (anti-PLA2R) are highly associated with disease activity and have been reported in at least 70% of patients with idiopathic membranous nephropathy (IMN). We present a case of a 56-year-old male with a 1 year history of hypertension, leg edema, and proteinuria, who presented with advanced renal failure and was found to have both ANCA-associated glomerulonephritis (GN) and IMN on kidney biopsy. Consistent with the idea that this is due to the chance occurrence of two independent diseases, we found both anti-MPO and anti-PLA2R antibodies in the patient's sera. Treatment with methylprednisolone, plasmapheresis, and cyclophosphamide resulted in improvement in kidney function and proteinuria, together with the simultaneous decrease in both autoantibodies. This is the first demonstration of two pathogenic antibodies giving rise to ANCA-associated GN and IMN in the same patient. It confirms the importance of classifying disease based upon the underlying mechanism, in addition to renal histopathology, to both optimize therapy and predict prognosis. |
| اللغة: | English |
| تدمد: | 2048-8513 2048-8505 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::579d91aafb9740a21e384c37b6f82fd0Test http://europepmc.org/articles/PMC3341840Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....579d91aafb9740a21e384c37b6f82fd0 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20488513 20488505 |
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