| Title | Plasma exchange and rituximab treatments in primary membranous nephropathy combined with crescentic glomerulonephritis A case report |
| Authors | Lu, Hui Cui, Zhao Zhou, Xu-jie Jin, Qi-zhuang Yu, Xiao-juan Wang, Su-xia Wang, Yu Zhou, Fu-de Zhao, Ming-hui |
| Affiliation | Peking Univ, Hosp 1, Dept Med, Renal Div, Beijing, Peoples R China Peking Univ, Inst Nephrol, Beijing, Peoples R China Peking Univ, Hosp 1, Minist Hlth China, Key Lab Renal Dis, Beijing, Peoples R China Peking Univ, Hosp 1, Minist Educ China, Key Lab CKD Prevent & Treatment, Beijing, Peoples R China Peking Univ, Hosp 1, Electron Microscopy Lab, Beijing, Peoples R China Peking Tsinghua Ctr Life Sci, Beijing, Peoples R China |
| Keywords | anti-phospholipase A2 receptor antibodies crescentic glomerulonephritis IgG3 membranous nephropathy plasma exchange |
| Issue Date | 2019 |
| Publisher | MEDICINE |
| Abstract | Rationale: Crescent formation is rare in primary membranous nephropathy (MN). Anti-phospholipase A2 receptor (PLA2R) antibodies are detectable in these patients. The mechanism and treatments are unknown. Patient concerns: A 72-year-old female patient who presented with nephrotic syndrome, hematuria, and rapidly progressive kidney dysfunction. Diagnoses: Kidney biopsy was performed and the diagnosis was MN in combination with crescentic glomerulonephritis. Circulating anti-PLA2R IgG3 and IgG4 were detected of high level. Interventions: The patient received plasma exchange and rituximab besides corticosteroids. Outcomes: The patient achieved complete remission of proteinuria and recovery of kidney function after the clearance of anti-PLA2R antibodies. Lesson: This case suggests a pathogenic role of anti-PLA2R antibodies in the mechanism of crescent formation in MN, which may need intensive therapy to eliminate the antibodies quickly. |
| URI | http://hdl.handle.net/20.500.11897/548497 |
| ISSN | 0025-7974 |
| DOI | 10.1097/MD.0000000000015303 |
| Indexed | SCI(E) EI |
| Appears in Collections: | 第一医院 |
