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Coexistence of ANCA-associated glomerulonephritis and anti-phospholipase A(2) receptor antibody-positive membranous nephropathy.

Publication ,  Journal Article
Surindran, S; Ayalon, R; Hasan, N; Beck, LH; Salant, DJ; Barisoni, L; Skolnik, EY; Beara-Lasic, L
Published in: Clin Kidney J
April 2012

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 A(2) receptor (anti-PLA(2)R) 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-PLA(2)R 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.

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Published In

Clin Kidney J

DOI

ISSN

2048-8505

Publication Date

April 2012

Volume

5

Issue

2

Start / End Page

162 / 165

Location

England

Related Subject Headings

  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Surindran, S., Ayalon, R., Hasan, N., Beck, L. H., Salant, D. J., Barisoni, L., … Beara-Lasic, L. (2012). Coexistence of ANCA-associated glomerulonephritis and anti-phospholipase A(2) receptor antibody-positive membranous nephropathy. Clin Kidney J, 5(2), 162–165. https://doi.org/10.1093/ndtplus/sfr149
Surindran, Sheena, Rivka Ayalon, Nazia Hasan, Laurence H. Beck, David J. Salant, Laura Barisoni, Edward Y. Skolnik, and Lada Beara-Lasic. “Coexistence of ANCA-associated glomerulonephritis and anti-phospholipase A(2) receptor antibody-positive membranous nephropathy.Clin Kidney J 5, no. 2 (April 2012): 162–65. https://doi.org/10.1093/ndtplus/sfr149.
Surindran S, Ayalon R, Hasan N, Beck LH, Salant DJ, Barisoni L, et al. Coexistence of ANCA-associated glomerulonephritis and anti-phospholipase A(2) receptor antibody-positive membranous nephropathy. Clin Kidney J. 2012 Apr;5(2):162–5.
Surindran, Sheena, et al. “Coexistence of ANCA-associated glomerulonephritis and anti-phospholipase A(2) receptor antibody-positive membranous nephropathy.Clin Kidney J, vol. 5, no. 2, Apr. 2012, pp. 162–65. Pubmed, doi:10.1093/ndtplus/sfr149.
Surindran S, Ayalon R, Hasan N, Beck LH, Salant DJ, Barisoni L, Skolnik EY, Beara-Lasic L. Coexistence of ANCA-associated glomerulonephritis and anti-phospholipase A(2) receptor antibody-positive membranous nephropathy. Clin Kidney J. 2012 Apr;5(2):162–165.

Published In

Clin Kidney J

DOI

ISSN

2048-8505

Publication Date

April 2012

Volume

5

Issue

2

Start / End Page

162 / 165

Location

England

Related Subject Headings

  • 3202 Clinical sciences