title: HIV-associated immune complex glomerulonephritis with "lupus-like" features.
abstract: Renal structural abnormalities in HIV/AIDS infected patients have been infrequently and incompletely reported in patients from sub-Saharan Africa. We report an immune complex glomerulonephritis with "lupus-like" features in a ten-year-old HIV+ boy who was evaluated at the University Hospital of Kinshasa. The light microscopic examination of the renal biopsy displayed a predominantly membranoproliferative glomerulonephritis with prominent focal segmental necrotizing injury, numerous wire-loops, and a spiky membranous nephropathy. In addition, there were prominent tubular injury, microcysts filled with periodic acid-Schiff (PAS) positive casts, edema and an inflammatory infiltrate of the interstitium, features of a classic HIV-associated nephropathy (HIVAN). Electron microscopy revealed large subendothelial, intra-membranous, subepithelial and mesangial deposits. The combination of these findings, while being consistent with lupus nephritis WHO grade IV/V, the tubulointerstitial HIVAN-like changes and the absence of clinical evidence of lupus disease favored an HIV-associated immune complex glomerulonephritis with "lupus-like features".
authors: Department of Pathology, University Hospital of Kinshasa, Democratic Republic of Congo. nmpakasa@free.fr
authors: Nestor M
authors: NM
authors: Pakasa
authors: P M
authors: PM
authors: Binda
mesh_terms: D016263:AIDS-Associated Nephropathy / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D000936:Antigen-Antibody Complex / Q000276:immunology*; D001706:Biopsy; D002648:Child; D003937:Diagnosis, Differential; D005921:Glomerulonephritis / Q000150:complications* / Q000276:immunology / Q000473:pathology; D006679:HIV Seropositivity / Q000150:complications* / Q000276:immunology / Q000473:pathology; D006801:Humans; D007105:Immune Complex Diseases / Q000150:complications* / Q000276:immunology / Q000473:pathology; D007678:Kidney Glomerulus / Q000648:ultrastructure*; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology / Q000473:pathology; D008297:Male; D008854:Microscopy, Electron
chemical_list: D000936:Antigen-Antibody Complex