Membranous nephropathy (bubbling appearance and spike formation) without immunoglobulin deposition in a patient with systemic lupus erythematosus.
A 53-year-old Japanese man with systemic lupus erythematosus developed proteinuria and hematuria after a urinary stone episode. A light microscopic study of a kidney biopsy specimen demonstrated a bubbling appearance and spike formation of the basement membrane. Immunofluorescent studies revealed that there were no significant depositions of immunoglobulins, such as IgG (-), IgA (-), IgM (+/-), kappa light chain (+/-), lambda light chain (+/-), or C3 (-) in the glomerular capillary wall, though C1q was present as one-plus positive staining in mesangial areas. Electron microscopic studies showed that the thickness of the basement membrane varied from thin to thick without electron dense deposits, and that the cellular components of the podocyte were irregularly present in the basement membrane. Urinary protein decreased after the usage of prednisolone and mizoribine; however, proteinuria aggravated after an episode of urinary stone during the same treatment.
Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute-cho, Aichi, 480-1195, Japan.
Naoto
N
Miura
Yuki
Y
Mori
Masabumi
M
Yoshino
Norihiro
N
Suga
Wataru
W
Kitagawa
Harutaka
H
Yamada
Kazuhiro
K
Nishikawa
Hirokazu
H
Imai
D050533:Glomerular Basement Membrane / Q000473:pathology / Q000648:ultrastructure; D015433:Glomerulonephritis, Membranous / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007136:Immunoglobulins / Q000032:analysis*; D008180:Lupus Erythematosus, Systemic / Q000276:immunology / Q000473:pathology*; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D050199:Podocytes / Q000473:pathology
D007136:Immunoglobulins