Primary Membranous Nephropathy with Crescents

We present the case of a 46-year-old patient with a history of hypertension, renal biopsy-proven primary membranous nephropathy, and a unique progression. He initially presented with edema and hypertension. Even though he responded initially to immunosuppression, later the clinical picture worsened,...

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Main Authors: Megana Sunder, Balagurunathan Raghavan, Saravanan Margabandhu
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-10-01
Series:Indian Journal of Kidney Diseases
Subjects:
Online Access:https://journals.lww.com/10.4103/ijkd.ijkd_36_23
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author Megana Sunder
Balagurunathan Raghavan
Saravanan Margabandhu
author_facet Megana Sunder
Balagurunathan Raghavan
Saravanan Margabandhu
author_sort Megana Sunder
collection DOAJ
description We present the case of a 46-year-old patient with a history of hypertension, renal biopsy-proven primary membranous nephropathy, and a unique progression. He initially presented with edema and hypertension. Even though he responded initially to immunosuppression, later the clinical picture worsened, prompting the need for a rebiopsy. A second renal biopsy revealed acute crescentic transformation superimposed on primary membranous glomerulonephritis. Immunohistochemistry confirmed Phospholipase A2 Receptor (PLA2R) staining positivity. Following pulse steroid therapy, the patient’s azotemia improved, and creatinine levels stabilized. This case highlights the rare occurrence of acute crescentic transformation in primary membranous nephropathy, emphasizing the challenges and complexities of management.
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series Indian Journal of Kidney Diseases
spelling doaj-art-ce6464e8a9e84c1586a244bcc449082a2025-08-20T02:31:12ZengWolters Kluwer Medknow PublicationsIndian Journal of Kidney Diseases2950-07612023-10-012414614910.4103/ijkd.ijkd_36_23Primary Membranous Nephropathy with CrescentsMegana SunderBalagurunathan RaghavanSaravanan MargabandhuWe present the case of a 46-year-old patient with a history of hypertension, renal biopsy-proven primary membranous nephropathy, and a unique progression. He initially presented with edema and hypertension. Even though he responded initially to immunosuppression, later the clinical picture worsened, prompting the need for a rebiopsy. A second renal biopsy revealed acute crescentic transformation superimposed on primary membranous glomerulonephritis. Immunohistochemistry confirmed Phospholipase A2 Receptor (PLA2R) staining positivity. Following pulse steroid therapy, the patient’s azotemia improved, and creatinine levels stabilized. This case highlights the rare occurrence of acute crescentic transformation in primary membranous nephropathy, emphasizing the challenges and complexities of management.https://journals.lww.com/10.4103/ijkd.ijkd_36_23anti-phospholipase a2 receptor antibody positive membranous nephropathycrescentic transformationcrescentic transformation of primary membranous nephropathymembranous glomerulonephritisprimary membranous nephropathyprimary membranous nephropathy with crescents
spellingShingle Megana Sunder
Balagurunathan Raghavan
Saravanan Margabandhu
Primary Membranous Nephropathy with Crescents
Indian Journal of Kidney Diseases
anti-phospholipase a2 receptor antibody positive membranous nephropathy
crescentic transformation
crescentic transformation of primary membranous nephropathy
membranous glomerulonephritis
primary membranous nephropathy
primary membranous nephropathy with crescents
title Primary Membranous Nephropathy with Crescents
title_full Primary Membranous Nephropathy with Crescents
title_fullStr Primary Membranous Nephropathy with Crescents
title_full_unstemmed Primary Membranous Nephropathy with Crescents
title_short Primary Membranous Nephropathy with Crescents
title_sort primary membranous nephropathy with crescents
topic anti-phospholipase a2 receptor antibody positive membranous nephropathy
crescentic transformation
crescentic transformation of primary membranous nephropathy
membranous glomerulonephritis
primary membranous nephropathy
primary membranous nephropathy with crescents
url https://journals.lww.com/10.4103/ijkd.ijkd_36_23
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