Glomerular Diseases

Ponticelli, Claudio; Glassock, Richard J.

doi:10.2215/cjn.04160413

Cited by 179 publications

(141 citation statements)

References 54 publications

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“…16 Most MN cases are iMN, representing a major cause of idiopathic NS among the adult population. 17 Despite various therapeutic strategies, the therapeutic effects are far from satisfactory.…”

Section: Discussionmentioning

confidence: 99%

The clinicopathological features of patients with membranous nephropathy

Zhu

Han

Zhang

et al. 2018

IJNRD

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Background: Membranous nephropathy (MN) represents a distinct glomerular disease which has been considered as a major cause of nephrotic syndrome (NS) in adults. Evidences show that the clinicopathological features of MN are various among MN cases. This study aimed to summarize and analyze the clinicopathological features of patients with MN. Methods: A total of 231 MN patients were recruited in this study. Their clinical and pathological features were collected and analyzed according to their age, gender, pathological stages, and anti-phospholipase A2 receptor (anti-PLA2R) antibodies tests. Results: Among the 231 MN cases, the ratio of male to female was 1.47 and the mean age was 47.43±14.32 years. Altogether, 163 (70.6%) cases were positive for NS. Their serum antiPLA2R, body mass index, total cholesterol, triglyceride, low density lipoprotein cholesterol, D2, IgA, and IgE were increased, but IgG was decreased. The majority of the patients were middle aged and old aged. In addition, the pathological stage was significantly correlated with gender (P=0.038), creatinine, (P=0.021) and IgE (P=0.003). A total of 74.9% MN patients were found to be positive for anti-PLA2R antibodies, and they were more likely to have abnormal serum indices. Conclusion:The major clinicopathological characteristics of MN patients are summarized in this study. Male and elder MN cases are likely to have rapid disease progression. Advanced pathological stages and being positive for anti-PLA2R antibodies may be potential indicators for disease activity of MN.

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Section: Discussionmentioning

confidence: 99%

The clinicopathological features of patients with membranous nephropathy

Zhu

Han

Zhang

et al. 2018

IJNRD

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“…Membranous nephropathy (MN), is a pathological entity characterized by diffuse thickening in the glomerular basement membrane, as viewed under light microscopy. Although 75% of MN cases are idiopathic, the remaining are associated with infections, malignancies, autoimmune diseases and drug toxicity (2).…”

Section: Introductionmentioning

confidence: 99%

A case of membranous glomerulopathy associated with lung cancer and review of the literature

et al. 2017

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Abstract. Membraneous nephropathy (MN) is the most commonly occurring nephrotic syndrome in adults as well as the most common paraneoplastic nephropathy associated with solid tumors, and it is mostly associated with gastrointestinal system and lung carcinomas. Accurate diagnosis is important as the treatment of paraneoplastic glomerulonephritis is very varied from that of idiopathic ones. In the current report, a case of a patient that was referred with proteinuria and edema and was diagnosed with lung cancer, and responded markedly to treatment of malignancy, with improvement of MN, is presented. Active cancer is present in all patients with paraneoplastic MN. In numerous patients, the paraneoplastic MN and cancer diagnoses are made within one year of each other. The treatment of paraneoplastic syndromes is usually associated with the treatment of primary malignancy. There are conflicting data on which treatment modality is more suitable. In conclusion, further studies are required in order to determine the actual incidence of cancer in patients with nephropathy, explain the physiopathological association between cancer and nephropathy and to determine the most suitable treatment approaches. IntroductionNephrotic syndrome is one of the most easily diagnosed kidney diseases due to its established criteria. It is a clinical entity characterized by proteinuria >3.5 g/1.73 m 2 for 24 h along with hypoalbuminemia, edema and hyperlipidemia. In glomerular diseases presenting with nephrotic syndrome, there is a defect in glomerular filtration barrier (1). Membranous nephropathy (MN), is a pathological entity characterized by diffuse thickening in the glomerular basement membrane, as viewed under light microscopy. Although 75% of MN cases are idiopathic, the remaining are associated with infections, malignancies, autoimmune diseases and drug toxicity (2).The diagnosis of paraneoplastic nephropathy is made according to certain criteria: Clinical and histological remission with complete removal of the tumor or complete remission with chemotherapy, nephrological relapse concurrent with the recurrence of malignancy and physiological connection between two diseases including tumor antigens and antitumor antibodies along with immune deposits (3). MN is the nephrotic syndrome occurring most frequently in adults and the paraneoplastic nephropathy detected most commonly in association with solid tumors (4), and it is most commonly associated with the gastrointestinal system and lung adenocarcinomas (1). Accurate diagnosis is important as the treatment of paraneoplastic glomerulonephritis is different from that of idiopathic nephropathies. The aim of the present report was to present the case of a patient who was referred with proteinuria and edema, was diagnosed with MN and subsequently lung cancer and responded markedly to treatment of malignancy with improvement of MN. Case reportA 62 year old male patient with a history of coronary artery disease and a history of smoking (36 pack-years) underwent kidney biopsy in July 2012 du...

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“…Second, marked elevation of proteinuria associated with increased eosinophils, seen in acute phase of atheroembolism, indicated that MN disease activity of MN and the renal atheroembolism were closely related to each other. Third, in terms of pathological findings, although EDDs are likely to be exclusively subepithelial and intramembranous in idiopathic MN [6], deposits were also detected in the mesangium in this case. Negative IgG4 in parafiin section also decrease the likelihood of primary MN.…”

Section: Discussionmentioning

confidence: 63%

“…MN is most often primary, although it has been associated with hepatitis B antigenemia, autoimmune diseases, malignancies, and the use of certain drugs such as gold, penicillamine, anti-TNF-alpha therapy, and nonsteroidal anti-inflammatory drugs [6].…”

Section: Discussionmentioning

confidence: 99%

Membranous Nephropathy Associated with Atheroembolism

Uchiyama¹,

Takemura²,

Ishibashi³

2017

TOUNJ

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Membranous nephropathy (MN) is one of the most common biopsy diagnoses in adults, and it has been associated with chronic infections, autoimmune diseases, malignancies, and drugs. However, MN associated with cholesterol crystal emboli has never been reported. Here we present a patient with MN as an unusual manifestation of atheroembolism.A 75-year-old man with worsening renal function after catheter ablation developed moderate proteinuria and underwent a renal biopsy. Findings on light, immunofluorescence, and electron microscopy were all compatible with membranous nephropathy. Moreover, one occluded interlobular artery contained a pathognomonic, biconvex, needle-shaped cleft, which indicated a cholesterol crystal emboli. The degree of proteinuria was in parallel with the number of eosinophils, which indicated a close relationship between MN disease activity and renal atheroembolism. Hypereosinophilic syndrome secondary to atheroembolism may cause MN; thus, corticosteroid therapy was likely to be effective.

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Glomerular Diseases

Cited by 179 publications

References 54 publications

The clinicopathological features of patients with membranous nephropathy

The clinicopathological features of patients with membranous nephropathy

A case of membranous glomerulopathy associated with lung cancer and review of the literature

Membranous Nephropathy Associated with Atheroembolism

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