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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 BMC+Nephrol
2018 ; 19
(1
): 120
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Anti-neutrophil cytoplasmic antibody-associated glomerulonephritis with detection
of myeloperoxidase and phospholipase A(2) receptor in membranous
nephropathy-lesions: report of two patients with microscopic polyangiitis
#MMPMID29792176
Tominaga K
; Uchida T
; Imakiire T
; Itoh K
; Shimazaki H
; Nakanishi K
; Kumagai H
; Oshima N
BMC Nephrol
2018[May]; 19
(1
): 120
PMID29792176
show ga
BACKGROUND: Podocyte phospholipase A(2) receptor (PLA(2)R) is a major target
antigen in idiopathic adult membranous nephropathy (MN). Histological PLA(2)R
staining in the renal tissue has proven to be useful for the detection of
idiopathic MN. However, glomerular PLA(2)R deposits have also been recently
observed in several patients with secondary MN, such as hepatitis B
virus-associated, hepatitis C virus-associated, and neoplasm-associated MN.
Certain inflammatory environments have been suggested to lead to abnormal
expression of PLA(2)R epitopes, with the resulting production of PLA(2)R
autoantibodies. CASE PRESENTATION: We report two patients diagnosed with
anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis with
MN-lesions, in whom ANCA titers for myeloperoxidase (MPO) were persistently
positive. The first patient was a 52-years-old man who presented with
interstitial pneumonitis. Microscopic hematuria and proteinuria were found when
the interstitial pneumonitis became more severe. Renal biopsy findings yielded a
diagnosis of ANCA-associated glomerulonephritis (mixed class) with MN-lesions.
The second patient was a 63-years-old woman who had been treated for relapsing
polychondritis. Her renal tissue showed evidence of focal ANCA-associated
glomerulonephritis with MN-lesions. Interestingly, both MPO and PLA(2)R were
detected in the glomerular subepithelial deposits of both patients.
Immunoglobulin G (IgG) 1 and IgG2 were positive in the glomeruli of patient 2,
and all subclasses of IgGs were positive in patient 1. CONCLUSION: The present
cases suggest that ANCA-associated glomerulonephritis could expose PLA(2)R,
leading to the development of MN-lesions.