Prognostic factors affecting long-term outcomes in patients with concurrent IgA nephropathy and membranous nephropathy

Qin, Yunlong; Yu, Zixian; Wu, Hao; Wang, Anjing; Wang, Fang; Wang, Di; Jia, Qing; Yuan, Jinguo; Xing, Yan; Zhang, Yumeng; Zhao, Jin; Sun, Shiren

doi:10.1016/j.heliyon.2023.e23436

Cited by 2 publications

(1 citation statement)

References 30 publications

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“…Therefore, the knowledge of reasonable methods for monitoring disease progression and assessing response to treatment will help to adjust treatment strategies in a timely manner and to achieve a better expected outcome. 237 …”

Section: Prognosis Of Mnmentioning

confidence: 99%

Membranous nephropathy: pathogenesis and treatments

Wang,

Yang,

Fang

et al. 2024

MedComm

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Membranous nephropathy (MN), an autoimmune disease, can manifest at any age and is among the most common causes of nephrotic syndrome in adults. In 80% of cases, the specific etiology of MN remains unknown, while the remaining cases are linked to drug use or underlying conditions like systemic lupus erythematosus, hepatitis B virus, or malignancy. Although about one‐third of patients may achieve spontaneous complete or partial remission with conservative management, another third face an elevated risk of disease progression, potentially leading to end‐stage renal disease within 10 years. The identification of phospholipase A2 receptor as the primary target antigen in MN has brought about a significant shift in disease management and monitoring. This review explores recent advancements in the pathophysiology of MN, encompassing pathogenesis, clinical presentations, diagnostic criteria, treatment options, and prognosis, with a focus on emerging developments in pathogenesis and therapeutic strategies aimed at halting disease progression. By synthesizing the latest research findings and clinical insights, this review seeks to contribute to the ongoing efforts to enhance our understanding and management of this challenging autoimmune disorder.

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Section: Prognosis Of Mnmentioning

confidence: 99%

Membranous nephropathy: pathogenesis and treatments

Wang,

Yang,

Fang

et al. 2024

MedComm

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Overlap of membranous nephropathy and IgA nephropathy in a patient with Kimura’s disease: a case report and literature review

Barbosa,

Neves,

Mohrbacher

et al. 2024

Front. Immunol.

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IntroductionKimura’s disease (KD) is a rare chronic inflammatory disorder characterized by subcutaneous lymphoid hyperplasia with peripheral eosinophilia. Kidney involvement is reported in 15%–18% of adult patients with KD, in many cases as nephrotic syndrome. We present a case of overlapping membranous nephropathy and IgA nephropathy associated with KD.Case reportA 27-year-old man was admitted with a history of bilateral leg edema for the last 2 months and concomitant progressive increase of cervical mass and fever. Laboratory findings were as follows: peripheral leukocyte count, 10,080/mm³; eosinophils, 3,200/mm³ (31.7%); serum creatinine, 0.83 mg/dL; and eGFR: 140 mL/min per 1.73 m2. Urinalysis revealed the presence of hematuria and proteinuria and the following results: 24-h proteinuria, 12.9 g; serum albumin, 1.3 g/dL; and elevated IgE level, 750 kU/L. Serologies for hepatitis B, hepatitis C, HIV, and VDRL were all negative. Complement C3 and C4 levels were normal. No monoclonal protein was detected in blood and urine. Parasite infestation was discarded. A biopsy of the cervical lymph node revealed eosinophilic lymphoid hyperplasia, suggesting KD. A kidney biopsy revealed findings consistent with the overlapping of membranous nephropathy with IgA nephropathy. The patient was treated for KD with prednisone 1 mg/kg/d with progressive dose tapering and posterior association of methotrexate 15 mg/week. A renin–angiotensin system inhibitor was prescribed for nephrotic syndrome. The cervical mass regressed, and proteinuria achieved partial remission, with an increase in serum albumin level and normalization of eosinophils and IgE levels.ConclusionAlthough uncommon, kidney involvement must be considered in patients with KD. Glomerular diseases are the most frequent form of kidney injury.

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Prognostic factors affecting long-term outcomes in patients with concurrent IgA nephropathy and membranous nephropathy

Cited by 2 publications

References 30 publications

Membranous nephropathy: pathogenesis and treatments

Membranous nephropathy: pathogenesis and treatments

Overlap of membranous nephropathy and IgA nephropathy in a patient with Kimura’s disease: a case report and literature review

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