A case of development of membranous nephropathy against the background of atypical hemolytic-uremic syndrome activated as a result of acute respiratory viral infection

Abstract

The article considers a clinical case of atypical hemolytic-uremic syndrome, which was the starting mechanism for the development of membranous nephropathy. Patient X. 23 years after acute respiratory viral infection, signs of nephrotic syndrome, arterial hypertension, and impaired kidney function appeared. Puncture nephrobiopsy was performed and the morphological picture corresponds to immunocomplex glomerulonephritis, most likely membranous nephropathy with the presence of segmental glomerulosclerosis, cellular half-moons. In parallel, the patient had verified signs of thrombotic microangiopathy in the form of microangiopathic anemia, thrombocytopenia, increased lactate dehydrogenase levels as a sign of cytolysis (primarily intravascular hemolysis). During the differential diagnosis, we stopped at the diagnosis of atypical hemolytic-uremic syndrome. The uniqueness of the described clinical case is that cases of glomerulonephritis against the background of atypical hemolytic-uremic syndrome are extremely rare, and membranous nephropathy is described for the first time.