Anti–Brush Border Antibody Disease (Anti-LRP2 Nephropathy) Associated With Lupus Nephritis

Dvanajscak, Zeljko; Murphy, Joel D.; Larsen, Christopher P.; Padala, Sandeep

doi:10.1016/j.ekir.2020.06.025

Cited by 12 publications

(14 citation statements)

References 9 publications

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“…Although ABBA disease has been reported in the setting of lupus nephritis (12), in our patient that diagnosis would not be suitable. IgG staining (mostly IgG4) in the apical surface of the tubular epithelium and the basolateral basement membrane is a typical finding in ABBA disease.…”

Section: Discussionmentioning

confidence: 62%

Case report: Isolated tubular basement membrane deposits in a patient with systemic lupus erythematosus - A diagnostic challenge

et al. 2022

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Lupus nephritis is one of the most serious and frequent manifestations of systemic lupus erythematosus. It usually presents in the first years of the disease, which suspicion should be raised in cases of elevated serum creatinine, presence of proteinuria above 500 mg/day or active urinary sediment, in the absence of other apparent causes such as urinary tract infection and use of nephrotoxic drugs. In most cases, it affects the glomerulus, and its presentation is rare in the form of isolated tubulo-interstitial disease. In this report, we describe a case of lupus nephritis diagnosed after 2 years of illness, in the form of atypical isolated tubular disease, characterized by massive deposits in the tubular basement membrane. Clinically, there were altered renal function, subnephrotic proteinuria, and evolution to a complete clinical response after immunosuppressive treatment.

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Section: Discussionmentioning

confidence: 62%

Case report: Isolated tubular basement membrane deposits in a patient with systemic lupus erythematosus - A diagnostic challenge

et al. 2022

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“…Any morphologically atypical appearing lymphoid populations in the biopsy should be further evaluated immunohistochemically for the presence of neoplasia. Anti-LRP2 nephropathy and primary kidney lym-phoma are both exceedingly rare, and our report may help to further shed light on this unusual association [1][2][3][4][5][6][7][8][9][10]16].…”

Section: Discussionmentioning

confidence: 97%

“…Anti-LDL receptor-related protein 2 (anti-LRP2) nephropathy, also called anti-brush border antibody disease, is a rare autoimmune kidney disease with fewer than 50 cases reported in the literature to date [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. The disease is characterized by peripheral circulating antibodies to LRP2, also known as megalin [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…The term “anti-brush border” antibody disease comes from the location of the target antigen LRP2 (megalin) which is found on proximal tubular brush borders. Anti-LRP2 nephropathy has been reported to occur de novo, or in association with other autoimmune diseases and malignancies [ 1 , 2 , 3 , 4 , 5 , 9 ]. We hereby report an unusual case of anti-LRP2 nephropathy, diagnosed concurrently in the same biopsy with extranodal marginal zone lymphoma.…”

Section: Introductionmentioning

confidence: 99%

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Anti-LDL Receptor-Related Protein 2 Nephropathy with Synchronous Primary Kidney Extranodal Marginal Zone Lymphoma

Ng¹,

Ruíz-Cordero²,

Caza³

et al. 2021

Glomerular Dis

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Introduction: Anti-LDL receptor-related protein 2 (anti-LRP2) nephropathy is a rare but progressive form of autoimmune-mediated tubulointerstitial nephritis and glomerular disease, characterized by a classic pattern of immune complex deposition in the kidney. A theoretic link between autoimmune disease and lymphoproliferative diseases exists, and therefore, in some cases autoimmune-mediated inflammation and lymphoproliferative neoplasm can co-exist in the same site. Case Presentation: An elderly man presented with 6 months of weight loss and fatigue. Subsequent workup showed an elevated serum creatinine and subnephrotic range proteinuria. Kidney biopsy was performed which revealed anti-LRP2 nephropathy with concurrent primary kidney extranodal marginal zone lymphoma. He was subsequently treated with rituximab but remains dialysis-dependent (12 months after his initial diagnosis, at time of publication of this report). Conclusion: We discuss the bidirectional relationship between autoimmune disease and lymphoma in the kidney, along with a brief review of the literature pertaining to these rare lesions. Our case report highlights the diagnostic difficulties faced by pathologists when encountering this entity. We also attempt to spread awareness about the co-existence of tubulointerstitial inflammation and lymphoproliferative disorder, which may be under-recognized.

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“…More recently, authors have described ABBA disease/anti-LRP2 nephropathy associated with lupus, 8 minimal change disease, 9 and lymphoma, 10 and highlighted the diagnostic difficulty faced by nephrologists and pathologists in the identification of this rare but likely underrecognized disease 11 , 12 ( Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

Antibrush Border Antibody Disease: A Case Report and Literature Review

et al. 2021

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Anti–Brush Border Antibody Disease (Anti-LRP2 Nephropathy) Associated With Lupus Nephritis

Cited by 12 publications

References 9 publications

Case report: Isolated tubular basement membrane deposits in a patient with systemic lupus erythematosus - A diagnostic challenge

Case report: Isolated tubular basement membrane deposits in a patient with systemic lupus erythematosus - A diagnostic challenge

Anti-LDL Receptor-Related Protein 2 Nephropathy with Synchronous Primary Kidney Extranodal Marginal Zone Lymphoma

Antibrush Border Antibody Disease: A Case Report and Literature Review

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