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2016 ; 11
(1
): 86
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Clinicopathological features of idiopathic membranous nephropathy combined with
IgA nephropathy: a retrospective analysis of 9 cases
#MMPMID27624606
Hu R
; Xing G
; Wu H
; Zhang Z
Diagn Pathol
2016[Sep]; 11
(1
): 86
PMID27624606
show ga
BACKGROUND: The concomitant presence of idiopathic membranous nephropathy and IgA
nephropathy is rare. Here, we report 9 cases of phospholipase-A2-receptor (PLA2R)
positive idiopathic membranous nephritis combined with IgA nephropathy, while
reviewing publications regarding the pathological characteristics of this
glomerolonephritis complication. CASE PRESENTATION: Nine cases of renal biopsy
tissues were retrospectively reviewed, including the clinicopathological
features, the results of the immunofluorescence assays, and the electron
microscopic examination. The patients mainly presented proteinuria and
microscopic hematuria, and the serum anti-PLA2R was detected as positive in all
of the patients. Histologically, a wide thickening of the glomerular basement
membrane was observed in each of the 9 cases. Additionally, there existed mild
hyperplasia in the mesangial cell and the matrix of the mesangial area.
Immunofluorescence assays showed prominent glomerular granular staining on the
glomerular capillary loops for IgG (++/+++), IgG4 (++/++++), and PLA2R (+/++). In
addition, moderate IgA positive stains were focally or sparsely limited to the
mesangial areas. Electron microscopy revealed subepithelial and mesangial
electron-dense deposits. CONCLUSIONS: The results from the case analyses
indicated that idiopathic membranous nephropathy combined with IgA nephropathy
possess the clinicopathological features found in both components. It is
suggested that serum anti-PLA2R and tissue PLA2R are important biomarkers that
can assist in the diagnosis of idiopathic membranous nephropathy associated with
IgA nephropathy.