[Clinicopathologic features of membranous nephropathy coexisting with IgA nephropathy].
OBJECTIVE
To study the clinicopathologic features of membranous nephropathy coexisting with IgA nephropathy.


METHODS
The renal biopsies performed in Peking University First Hospital during the period from January, 1998 to April, 2006 were retrospectively reviewed. The clinicopathologic features of 11 cases of membranous nephropathy coexisting with IgA nephropathy were studied. Electron microscopy with immunogold labeling for IgG and IgA were also performed.


RESULTS
The mean age of patients was 39.9 years. The male-to-female ratio was 1:2.9. The patients mainly presented with proteinuria. Proteinuria of nephrotic level was seen in 7 cases (63.6%). Seven cases also had associated microscopic hematuria. None of them showed evidence of renal insufficiency. Cases with secondary diseases, such as hepatitis virus infection and systemic lupus erythematosus, were excluded from the study. Histologically, vacuolation and thickening of glomerular basement membrane was seen. There was also mild mesangial hypercellularity and increase in mesangial matrix. Occasional glomeruli with crescent formation were identified in 2 cases. Immunofluorescence study showed granular staining for IgG and C3 along glomerular capillary walls, in addition to clumps of IgA deposits in mesangium. Electron microscopy revealed subepithelial and mesangial electron-dense deposits. Immunogold labeling showed IgG and IgA localized in the subepithelial and mesangial deposits respectively.


CONCLUSIONS
Membranous nephropathy coexisting with IgA nephropathy possesses the clinicopathologic features of both components. It might be caused by independent occurrence of the two entities.
Wang
Su-xia
SX
Department of Nephrology, Peking University First Hospital and Institute of Nephrology, Peking University, Beijing 100034, China. sxwzjp@sina.com
Zou
Wan-zhong
WZ
Yang
Li
L
Zhao
Ming-hui
MH
D000328:Adult; D005260:Female; D050533:Glomerular Basement Membrane / Q000276:immunology / Q000473:pathology / Q000648:ultrastructure; D005920:Glomerular Mesangium / Q000276:immunology / Q000473:pathology / Q000648:ultrastructure; D005922:Glomerulonephritis, IGA / Q000150:complications / Q000276:immunology / Q000473:pathology*; D015433:Glomerulonephritis, Membranous / Q000150:complications / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007070:Immunoglobulin A / Q000378:metabolism; D007074:Immunoglobulin G / Q000378:metabolism*; D007678:Kidney Glomerulus / Q000276:immunology / Q000473:pathology* / Q000648:ultrastructure; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D007070:Immunoglobulin A; D007074:Immunoglobulin G