Membranous glomerulonephritis – a common, unspecific pattern of glomerular injury

Starzyńska-Kubicka, Aleksandra; Perkowska‐Ptasińska, Agnieszka; Górnicka, Barbara

doi:10.5114/pjp.2018.79540

Cited by 6 publications

(5 citation statements)

References 89 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…MN is a disease characterized by immune complex deposition on subepithelial glomerular capillaries [3]. Primary or idiopathic MN accounts for about two-thirds of cases.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Case of Membranous Nephropathy Hypothesized to be Associated With COVID-19 Vaccine

Rashid¹,

Mousa²,

Khan³

et al. 2022

Cureus

View full text Add to dashboard Cite

A 56-year-old male patient with a medical history of essential hypertension was referred to the emergency room after he was found to have a serum creatinine level of 13 mg/dL at his primary care physician's office. The patient reported that he had developed a coronavirus disease 2019 (COVID-19)-like infection six months prior that was not confirmed. Two months later, he started to notice dyspnea on exertion and bilateral lower limb swelling and was started on furosemide. He received the first dose of the Moderna COVID-19 vaccine a month before the presentation but did not receive the second dose. Subsequently, his lower limb swelling and exertional dyspnea started worsening. He denied any new medication, dysuria, oliguria, hematuria, fever, or any other symptoms. Initial evaluation was consistent with kidney failure. Hypocalcemia and hyperphosphatemia were noted, along with medical renal disease on renal ultrasound. Eosinophils and nephrotic-range proteinuria were found in the urine. His serum phospholipase A2 receptor (PLA2R) antibodies were positive. A renal biopsy showed membranous glomerulonephritis with moderate segmental sclerosis, as well as tubulointerstitial fibrosis with neutrophils, consistent with acute interstitial nephritis. Positive staining for PLA2R in the glomerular deposits suggested primary membranous nephropathy (MN). He was treated with prednisone first, and when the kidney biopsy was conclusive for membranous glomerulopathy, he was started on rituximab. On admission, he received hemodialysis intermittently, but this was stopped a month after discharge as his renal function normalized. Recently, there have been numerous cases reported with new onset of glomerular disease after receiving the COVID-19 vaccine. Further studies of vaccinated patients are needed to determine whether the severe acute respiratory syndrome coronavirus 2 virus vaccination is associated with a higher risk of MN and to identify potential predisposing factors and mechanisms of kidney injury in patients in whom it occurs.

show abstract

“…MN is a disease characterized by immune complex deposition on subepithelial glomerular capillaries [3]. Primary or idiopathic MN accounts for about two-thirds of cases.…”

Section: Discussionmentioning

confidence: 99%

“…Secondary causes of MN include autoimmune diseases, medications, malignancies, and infections [2]. Overall, 70-80% of patients with primary MN are found to have PLA2R1 antibodies [3]. A smaller percentage of patients with secondary MN have anti-PLA2R1 antibodies as well [4].…”

Section: Discussionmentioning

confidence: 99%

A Case of Membranous Nephropathy Hypothesized to be Associated With COVID-19 Vaccine

Rashid¹,

Mousa²,

Khan³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…The opening on the GBM is normally covered by vascular endothelium. However, in MN, complement complexes might injure the GBM by inducing the production of reactive oxygen species, thus altering the membrane structure [16]. At that time, a large proportion of the immune complex might have passed through the GBM from the glomerular capillary luminal side toward the epithelial side and nephrosis developed.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Low-Vacuum Scanning Electron Microscopy to Assess Histopathological Resolution of Class V Lupus Nephritis: A Case Report

Yoshida

Hirashio

Doi

et al. 2021

Case Rep Nephrol Dial

View full text Add to dashboard Cite

Lupus nephritis (LN) is most frequently associated with poor outcomes in patients with systemic lupus erythematosus (SLE). LN manifests as histopathological changes in the kidney caused by immune complex formation and deposition. In particular, immunoglobulin G (IgG) deposits are frequently observed by immunofluorescence staining, which helps to establish the diagnosis of LN. In this case report, we describe a 57-year-old woman with SLE who had been undergoing treatment on an outpatient basis for 11 years. Her first and second renal biopsies revealed class V LN with a coarsely granular pattern of IgG deposition in the peripheral capillary walls. However, her third renal biopsy showed no IgG deposition, which indicated histopathological resolution of her class V LN. We used low-vacuum scanning electron microscopy (LV-SEM) to examine the three-dimensional structural alterations in her glomerular basement membranes. In this report, we describe findings that indicated resorption of epithelial deposits, that is, resolution of LN. The results of repeated kidney biopsies confirmed by LV-SEM suggested the possibility of a state unrelated to LN.

show abstract

“…Se ha visto que los corticosteroides y los agentes alquilantes usados en combinación fueron útiles para mantener y preservar la función renal a largo plazo. Recientemente, rituximab ha jugado un papel importante, ya que evita la nefrotoxicidad a largo plazo asociada con los agentes alquilantes y los inhibidores de la calcineurina y también evita el alto riesgo de recaída (Hemanth Kumar et al, 2022;Starzyńska-Kubicka et al, 2018).…”

Section: Introductionunclassified

“…Estos hallazgos respaldan el papel de la respuesta inflamatoria y la lesión celular en la patogénesis de la NM (Starzyńska-Kubicka et al, 2018). El gen transductor de señal y activador de la transcripción 4 (STAT4), ubicado en el cromosoma 2q32.2-32.3, codifica un factor de transcripción que desempeña un papel esencial en el desarrollo de la inflamación de diversas enfermedades inmunomediada (Chen et al, 2011).…”

Section: Introductionunclassified

Actualización del tratamiento de la glomerulonefritis membranosa primaria

Pozo Guzmán,

Bueno Castro

2023

ConcienciaDigital

View full text Add to dashboard Cite

Introducción: la nefropatía membranosa (MN) representa un trastorno glomerular caracterizado por el engrosamiento de las paredes capilares debido a inmunocomplejos. Esta afección prevalece como la causa principal del síndrome nefrótico en adultos no diabéticos mayores de 40 años, aunque también afecta a niños con menor frecuencia. La incidencia estimada varía geográficamente, pero permanece limitada por la falta de estudios representativos. Aunque mayormente autoinmune y relacionada con anticuerpos anti-PLA2R, el tratamiento aborda nuevas terapias y descubrimientos de anticuerpos emergentes. Metodología: se realizará una revisión bibliográfica para recopilar y analizar estudios relevantes sobre el tratamiento de la glomerulonefritis membranosa primaria, utilizando criterios de inclusión específicos. Se excluyeron artículos no pertinentes y la búsqueda abarcó bases de datos como PubMed, Web of Science y ProQuest, empleando términos de búsqueda y operadores booleanos. Discusión: diversos estudios sobre el tratamiento de la glomerulonefritis membranosa primaria revelan enfoques variables. La ciclofosfamida aceleró la recuperación en un estudio, mientras que la prednisona y el rituximab tuvieron resultados limitados. La cantidad de proteinuria resultó clave para preservar la función renal. La terapia inmunosupresora fue más efectiva que la no inmunosupresora en general. La detección de altos niveles de anticuerpos anti-PLA2R indicó mala respuesta al tacrolimus. La disfunción tiroidea y el rituximab afectaron los resultados. La terapia guiada por anticuerpos mostró altas tasas de remisión. La aspirina o warfarina profilácticas pueden ser beneficiosas en pacientes con baja albúmina sérica. Conclusión: El tratamiento de la nefropatía membranosa idiopática es complejo. Rituximab y terapia guiada por anticuerpos son efectivos, pero la elección depende de factores como edad, anticuerpos, función tiroidea y otros. Se necesita un enfoque personalizado para mejorar la remisión y calidad de vida del paciente. Área de estudio general: Medicina. Área de estudio específica: Nefrología. Tipo de estudio: Revisión Bibliográfica.

show abstract

Membranous glomerulonephritis – a common, unspecific pattern of glomerular injury

Cited by 6 publications

References 89 publications

A Case of Membranous Nephropathy Hypothesized to be Associated With COVID-19 Vaccine

A Case of Membranous Nephropathy Hypothesized to be Associated With COVID-19 Vaccine

Low-Vacuum Scanning Electron Microscopy to Assess Histopathological Resolution of Class V Lupus Nephritis: A Case Report

Actualización del tratamiento de la glomerulonefritis membranosa primaria

Contact Info

Product

Resources

About