title: Clinical and Immunologic Characteristics of Patients With ANCA-Associated Glomerulonephritis Combined With Membranous Nephropathy: A Retrospective Cohort Study in a Single Chinese Center.
abstract: The concurrent antineutrophil cytoplasmic antibody-associated glomerulonephritis (ANCA-GN) and membranous nephropathy (MN) have been increasingly documented, mainly in case studies and case series; however, the differences of clinical and pathologic characteristics as well as outcomes between ANCA-GN patients with and without MN remain unclear. The current study investigated the clinical and immunologic features of patients with combined ANCA-GN and MN in a large cohort. Twenty-seven of 223 patients had combined ANCA-GN and MN; they had significantly higher levels of initial serum creatinine, higher Birmingham Vasculitis Activity Score and poorer renal outcome than ANCA-GN patients without MN (P < 0.05). ANCA-GN patients with MN could recognize the light chain of myeloperoxidase more frequently than those without MN (P < 0.05). The prevalence of circulating anti-PLA2R antibodies and glomerular PLA2R deposits was significantly lower in patients with combined ANCA-GN and MN than that in patients with idiopathic MN (P < 0.05). Compared with the idiopathic MN patients, the patients with combined ANCA-GN and MN had significantly higher recognition frequency of immunoglobulin (Ig) G2 and IgG3, and significantly lower recognition frequency of IgG4 (P < 0.05). Patients with combined ANCA-GN and MN had distinct clinical features and a different pathogenesis of MN.
authors.affiliation: From the Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology (RZ, GL, ZC, MC, M-HZ); Key Laboratory of Renal Disease, Ministry of Health of China (RZ, GL, ZC, MC, M-HZ); Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Peking-Tsinghua Center for Life Sciences; Beijing, China (RZ, GL, ZC, MC, M-HZ); and Renal Division, Department of Medicine, Wuhan Integrated TCM and Western Medicine Hospital; Wuhan, China (RZ).
authors.forename: Rong
authors.initials: R
authors.lastname: Zou
authors.forename: Gang
authors.initials: G
authors.lastname: Liu
authors.forename: Zhao
authors.initials: Z
authors.lastname: Cui
authors.forename: Min
authors.initials: M
authors.lastname: Chen
authors.forename: Ming-Hui
authors.initials: MH
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D002681:China / Q000453:epidemiology; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000276:immunology* / Q000401:mortality / Q000473:pathology; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism; D007668:Kidney / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009195:Peroxidase / Q000276:immunology; D054507:Receptors, Phospholipase A2 / Q000276:immunology / Q000378:metabolism
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D007074:Immunoglobulin G; D054507:Receptors, Phospholipase A2; D009195:Peroxidase