A Case of Membranous Glomerulonephropathy Associated with Takayasu's Arteritis.
Glomerulonephropathy is a rare complication of Takayasu's arteritis (TA). To date, most glomerulonephropathies associated with TA show the histological feature of mesangial proliferation. Membranous glomerulonephropathy (MG) is a form of glomerulonephropathy in which the mesangial proliferation is not conspicuous and its association with TA is extremely rare. A 54-year-old man was referred to our hospital due to progressive edema in the lower limbs and nephrotic range proteinuria. Five years previously, he underwent percutaneous angioplasty for left subclavian artery stenosis. Kidney biopsy revealed stage II MG. General examination including enhanced CT scan confirmed the presence of TA. He started oral prednisolone therapy at a dose of 40 mg daily. The C-reactive protein level normalized 7 days after the prednisolone therapy. Three months later, proteinuria had remitted. Though the true relationship between MG and TA was not revealed in present case, considering the fact that complete remission of nephrotic syndrome occurred following the improvement of C-reactive protein level in response to steroid therapy, TA might be the secondary cause of MG. To our best knowledge, only two case reports described the association of MG and TA previously. Those two patients, however, also demonstrated the feature of systemic lupus erythematosus in addition to TA. This is the first case report that describes a patient who presented as MG associated with TA, but not complicated by systemic lupus erythematosus.
Department of Nephrology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan.
Ryo
R
Koda
Department of Nephrology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan.
Atsunori
A
Yoshino
Department of Nephrology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan.
Yuji
Y
Imanishi
Department of Nephrology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan.
Shinya
S
Kawamoto
Department of Pathology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan.
Yoshihiko
Y
Ueda
Department of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Junichiro James
JJ
Kazama
Department of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Ichiei
I
Narita
Department of Nephrology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan.
Tetsuro
T
Takeda
Aortitis syndrome; Membranous glomerulonephropathy; Nephrotic syndrome; Systemic lupus erythematosus; Takayasu's arteritis