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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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-10-01
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| Series: | Indian Journal of Kidney Diseases |
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| 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. |
| format | Article |
| id | doaj-art-ce6464e8a9e84c1586a244bcc449082a |
| institution | OA Journals |
| issn | 2950-0761 |
| language | English |
| publishDate | 2023-10-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| 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 |
| work_keys_str_mv | AT meganasunder primarymembranousnephropathywithcrescents AT balagurunathanraghavan primarymembranousnephropathywithcrescents AT saravananmargabandhu primarymembranousnephropathywithcrescents |