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Membranous glomerulopathy with superimposed pauci-immune necrotizing crescentic glomerulonephritis.

Fatima H, Siew ED, Dwyer JP, Paueksakon P - Clin Kidney J (2012)

Bottom Line: We describe a 61-year-old woman with acute kidney injury, nephrotic range proteinuria and hematuria.Coexistent MG and PNCGN is a rare occurrence.We also review previous reported cases and discuss possible pathogenesis of this rare dual glomerulopathy.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Microbiology and Immunology (MCN C2318B) , Vanderbilt University Medical Center , Nashville, TN , USA.

ABSTRACT
We describe a 61-year-old woman with acute kidney injury, nephrotic range proteinuria and hematuria. Kidney biopsy showed membranous glomerulopathy (MG) with superimposed pauci-immune necrotizing crescentic glomerulonephritis (PNCGN). Coexistent MG and PNCGN is a rare occurrence. The diagnosis of such an exceptionally rare combination relies on the combination of renal biopsy findings and serologic testing. We also review previous reported cases and discuss possible pathogenesis of this rare dual glomerulopathy.

No MeSH data available.


Related in: MedlinePlus

A glomerulus with fibrocellular crescent (arrow) and segmental sclerosis with adhesion (Periodic acid-Shiff (PAS) stain, original magnification ×400).
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SFS145F2: A glomerulus with fibrocellular crescent (arrow) and segmental sclerosis with adhesion (Periodic acid-Shiff (PAS) stain, original magnification ×400).

Mentions: The renal biopsy specimen included two pieces of cortex containing nine glomeruli, four of which were globally sclerosed. There was mild increase in mesangial matrix and cellularity but no endocapillary proliferation. The GBM showed very rare spikes and rare holes (Figure 1), segmental corrugation and split appearance. Two glomeruli had fibrinoid necrosis with fibrocellular crescents and segmental sclerosis with adhesions (Figure 2). There was ∼40% interstitial fibrosis with proportional tubular atrophy and mild lymphoplasmacytic infiltrate. There was ATI involving ∼20% of tubular profiles with sloughing off of tubular epithelial cells. There were rare proteinaceous casts. There were no crystals or polarizable material. Arterioles were unremarkable. Interlobular arteries showed mild tortuosity without fibrinoid necrosis or inflammation.Fig. 1.


Membranous glomerulopathy with superimposed pauci-immune necrotizing crescentic glomerulonephritis.

Fatima H, Siew ED, Dwyer JP, Paueksakon P - Clin Kidney J (2012)

A glomerulus with fibrocellular crescent (arrow) and segmental sclerosis with adhesion (Periodic acid-Shiff (PAS) stain, original magnification ×400).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400567&req=5

SFS145F2: A glomerulus with fibrocellular crescent (arrow) and segmental sclerosis with adhesion (Periodic acid-Shiff (PAS) stain, original magnification ×400).
Mentions: The renal biopsy specimen included two pieces of cortex containing nine glomeruli, four of which were globally sclerosed. There was mild increase in mesangial matrix and cellularity but no endocapillary proliferation. The GBM showed very rare spikes and rare holes (Figure 1), segmental corrugation and split appearance. Two glomeruli had fibrinoid necrosis with fibrocellular crescents and segmental sclerosis with adhesions (Figure 2). There was ∼40% interstitial fibrosis with proportional tubular atrophy and mild lymphoplasmacytic infiltrate. There was ATI involving ∼20% of tubular profiles with sloughing off of tubular epithelial cells. There were rare proteinaceous casts. There were no crystals or polarizable material. Arterioles were unremarkable. Interlobular arteries showed mild tortuosity without fibrinoid necrosis or inflammation.Fig. 1.

Bottom Line: We describe a 61-year-old woman with acute kidney injury, nephrotic range proteinuria and hematuria.Coexistent MG and PNCGN is a rare occurrence.We also review previous reported cases and discuss possible pathogenesis of this rare dual glomerulopathy.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Microbiology and Immunology (MCN C2318B) , Vanderbilt University Medical Center , Nashville, TN , USA.

ABSTRACT
We describe a 61-year-old woman with acute kidney injury, nephrotic range proteinuria and hematuria. Kidney biopsy showed membranous glomerulopathy (MG) with superimposed pauci-immune necrotizing crescentic glomerulonephritis (PNCGN). Coexistent MG and PNCGN is a rare occurrence. The diagnosis of such an exceptionally rare combination relies on the combination of renal biopsy findings and serologic testing. We also review previous reported cases and discuss possible pathogenesis of this rare dual glomerulopathy.

No MeSH data available.


Related in: MedlinePlus