Membranous lupus nephritis with antineutrophil cytoplasmic antibody-associated segmental necrotizing and crescentic glomerulonephritis.
Focal segmental necrotizing and crescentic lupus nephritis accompanied by perinuclear antineutrophil cytoplasmic antibody (P-ANCA) seropositivity is an unusual occurrence. We report the first biopsy-documented cases of membranous lupus nephritis class V with associated "pauci-immune" segmental necrotizing glomerulonephritis and P-ANCA seropositivity. The absence of subendothelial electron-dense deposits favored a manifestation of superimposed ANCA-associated glomerulonephritis rather than class III lupus nephritis. The pathogenetic implications of this association are explored.
Marshall
S
S
Department of Pathology, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
Dressler
R
R
D'Agati
V
V
D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005923:Glomerulosclerosis, Focal Segmental / Q000175:diagnosis*; D006801:Humans; D007668:Kidney / Q000473:pathology; D008181:Lupus Nephritis / Q000175:diagnosis*; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged
D019268:Antibodies, Antineutrophil Cytoplasmic