Epitope Spreading: The Underlying Mechanism for Combined Membranous Lupus Nephritis and Anti-GBM Disease?

Membranous lupus nephritis associated with anti-GBM antibodies is a rare entity, particularly in lupus nephritis patients who are serologically negative for ANA and anti-dsDNA with normal complement levels. We present an unusual case of a patient initially diagnosed with anti-GBM disease whose repea...

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Published in:Case reports in nephrology 2023-01, Vol.2023, p.1-6
Main Authors: Sogbein, Olusola, Kochar, Tina, Afrouzian, Marjan
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Language:English
Subjects:
Antibodies
Biopsy
Blood
Case Report
Case reports
Creatinine
Disease
Genes
Lupus
Medical research
Microscopy
Neutrophils
Patients
Serology
Urine
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Kochar, Tina
Afrouzian, Marjan
description Membranous lupus nephritis associated with anti-GBM antibodies is a rare entity, particularly in lupus nephritis patients who are serologically negative for ANA and anti-dsDNA with normal complement levels. We present an unusual case of a patient initially diagnosed with anti-GBM disease whose repeat biopsy demonstrated combined focal proliferative and membranous lupus nephritis (III + V). The first biopsy showed a granular linear pattern, and the second biopsy had multiple electron dense deposits in the subendothelial, epithelial, and mesangial regions along with podocyte effacement. Experimental research suggests that the sequential histopathological transition observed may reflect the action of immunological rearrangement and epitope spreading.
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source PubMed (Medline); Wiley-Blackwell Open Access Collection; Publicly Available Content Database
subjects Antibodies
Biopsy
Blood
Case Report
Case reports
Creatinine
Disease
Genes
Lupus
Medical research
Microscopy
Neutrophils
Patients
Serology
Urine
title Epitope Spreading: The Underlying Mechanism for Combined Membranous Lupus Nephritis and Anti-GBM Disease?
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