Evolution of Membranous Nephropathy into Anti-Glomerular-Basement-Membrane Glomerulonephritis

Klassen, John S.; Elwood, Charles M.; Grossberg, Allan L.; Milgrom, Felix; Montes, Mario; Sepulveda, Marion; Andres, Giuseppe A.

doi:10.1056/nejm197406132902403

Cited by 109 publications

(61 citation statements)

References 12 publications

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“…Previous studies have reported 40 cases of coexisting (not including the current case) anti-GBM glomerulonephritis and MN (Klassen et al 1974;Troxell et al 2006;Nayak and Satish 2007;Patel et al 2010;Mori et al 2012;Tan et al 2013;Bandak et al 2014;Jia et al 2014). compared eight cases of coexisting anti-GBM glomerulonephritis and MN with 30 cases of anti-GBM glomerulonephritis alone and found that the incidences of oliguria/anuria and gross hematuria were lower in cases of coexisting anti-GBM glomerulonephritis and MN compared with anti-GBM glomerulonephritis alone.…”

Section: Discussionmentioning

confidence: 77%

“…The clinical characteristics of 32 cases are presented in Table 2 (Klassen et al 1974;Troxell et al 2006;Nayak and Satish 2007;Patel et al 2010;Mori et al 2012;Tan et al 2013;Bandak et al 2014;Jia et al 2014), excluding the eight cases reported by Jia et al (2014), because we were unable to obtain the detail data. Median age of the 32 cases is 47 years and median serum creatinine level is 3.4 mg/dL.…”

Section: Discussionmentioning

confidence: 99%

“…For their prognosis of these 11 cases, five ended with end-stage renal disease and underwent dialysis or died, five showed improved kidney function, and the prognosis for one patient was unknown (Klassen et al 1974;Troxell et al 2006;Nayak and Satish 2007;Patel et al 2010;Mori et al 2012;Tan et al 2013;Bandak et al 2014). Troxell et al (2006) examined the relationship between the order of onset of two diseases (anti-GBM glomerulonephritis and MN) and renal prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…Several cases of coexisting anti-GBM glomerulonephritis and MN have been reported (Klassen et al 1974;Troxell et al 2006;Nayak and Satish 2007;Patel et al 2010;Mori et al 2012;Tan et al 2013;Bandak et al 2014;Jia et al 2014). Some reports suggest cases in which there is preserved renal function (Troxell et al 2006), despite the development of anti-GBM glomerulonephritis.…”

Section: Introductionmentioning

confidence: 99%

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Coexistence of Anti-Glomerular Basement Membrane Glomerulonephritis and Membranous Nephropathy in a Female Patient with Preserved Renal Function

Ogawara

Harada

Ichikawa

et al. 2017

Tohoku J. Exp. Med.

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Renal prognosis for anti-glomerular basement membrane (GBM) glomerulonephritis is poor. The greater the amount of anti-GBM antibody binding the antigen (type IV collagen of the glomerular basement membrane), the greater the number of crescents that develop in glomeruli, resulting in progression of renal impairment. Immunofluorescence staining reveals linear IgG depositions on glomerular capillary walls. Membranous nephropathy (MN) is one of the most common causes of nephrotic syndrome in middle-aged to elderly patients. Immune complex is deposited in the sub-epithelial space of the glomerulus resulting in the development of a membranous lesion. Immunofluorescence staining reveals granular IgG depositions on glomerular capillary walls. Coexisting anti-GBM glomerulonephritis and MN are rare and, here we report a case of coexisting anti-GBM glomerulonephritis and MN with preserved renal function. There are some cases of coexisting anti-GBM glomerulonephritis and MN do not show severely decreased renal function. A 76-year-old Japanese woman presented with nephrotic syndrome, microscopic hematuria, and was positive for anti-GBM antibody. Kidney biopsy revealed linear and granular IgG depositions in glomerular capillary walls, crescent formations, and electron-dense deposits in the sub-epithelial space. She was diagnosed with anti-GBM glomerulonephritis and MN. Steroid and cyclosporine therapy achieved complete remission, and kidney function was preserved. In conclusion, coexisting anti-GBM glomerulonephritis and MN can have preserved renal function. IgG subclass of deposited anti-GBM antibody may be associated with the severity of anti-GBM glomerulonephritis. In addition, in the case of nephrotic syndrome with hematuria, we should consider the possibility of coexisting anti-GBM glomerulonephritis and MN.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Coexistence of Anti-Glomerular Basement Membrane Glomerulonephritis and Membranous Nephropathy in a Female Patient with Preserved Renal Function

Ogawara

Harada

Ichikawa

et al. 2017

Tohoku J. Exp. Med.

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show abstract

“…2 We have identified 25 reported cases in addition to the one presented here of either membranous nephropathy followed by anti-GBM glomeru-lonephritis, mostly in middle-aged or older patients (n ϭ 6); anti-GBM glomerulonephritis followed by membranous nephropathy, mostly in younger adults (n ϭ 6); or simultaneous findings of membranous nephropathy and anti-GBM disease (n ϭ 13) ( Table 1). Primary membranous nephropathy is due to antibodies reacting to planted, endogenous, podocyte-related antigens, recently demonstrated to be the phospholipase A2 receptor in many cases, 29,30 and an HLA-DQA1 allele on chromosome 6p21 is most closely associated with these antibodies in Caucasians.…”

Section: Discussionmentioning

confidence: 81%

Membranous Nephropathy with Crescents

Basford¹,

Lewis²,

Dwyer³

et al. 2011

Journal of the American Society of Nephrology

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Nephritogenic Immune Responses Involving Basement Membrane and Other Antigens in or of the Glomerulus

Wilson

1983

Immune Mechanisms in Renal Disease

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Evolution of Membranous Nephropathy into Anti-Glomerular-Basement-Membrane Glomerulonephritis

Cited by 109 publications

References 12 publications

Coexistence of Anti-Glomerular Basement Membrane Glomerulonephritis and Membranous Nephropathy in a Female Patient with Preserved Renal Function

Coexistence of Anti-Glomerular Basement Membrane Glomerulonephritis and Membranous Nephropathy in a Female Patient with Preserved Renal Function

Membranous Nephropathy with Crescents

Nephritogenic Immune Responses Involving Basement Membrane and Other Antigens in or of the Glomerulus

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