Membranous glomerulopathy induced by myeloperoxidase-anti-neutrophil cytoplasmic antibody-related crescentic glomerulonephritis.
A 68-year-old woman was referred for evaluation of nephrotic-range proteinuria and a course suggesting rapidly progressive glomerulonephritis. Serum anti-neutrophil cytoplasmic antibody against myeloperoxidase (MPO) was 204 U/ml. A renal biopsy specimen revealed necrotizing glomerulonephritis with crescent formation. However, immunofluorescence showed staining with IgG and C3 along capillary walls. IgG positivity included both IgG1 and IgG4. Electron microscopic examination disclosed both paramesangial and subepithelial deposits. This case suggests that rarely, MPO-ANCA-related crescentic glomerulonephritis may present nephrotic-range proteinuria and show immune deposits along capillary walls.
Suwabe
Tatsuya
T
Nephrology Center, Toranomon Hospital, Tokyo, Japan.
Ubara
Yoshifumi
Y
Tagami
Tetsuo
T
Sawa
Naoki
N
Hoshino
Junichi
J
Katori
Hideyuki
H
Takemoto
Fumi
F
Hara
Shigeko
S
Aita
Kumi
K
Hara
Shigeo
S
Takaichi
Kenmei
K
D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D005260:Female; D005921:Glomerulonephritis / Q000150:complications* / Q000175:diagnosis / Q000276:immunology*; D015433:Glomerulonephritis, Membranous / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D006801:Humans; D009195:Peroxidase / Q000276:immunology*
D019268:Antibodies, Antineutrophil Cytoplasmic; D009195:Peroxidase