Abstract
A 60-year-old man presented with nephrotic syndrome (NS). Light microscopy of renal biopsy specimens showed minor glomerular abnormalities, while immunofluorescence microscopy revealed solitary polyclonal granular IgA deposition along the glomerular capillary walls. Electron microscopy showed small amounts of electron-dense deposits in the subepithelial area, but not in the mesangial area. In this patient, apparent underlying disease was not found during the 3-year follow-up, and low-dose prednisolone was effective in the treatment of NS. To our knowledge, there is only one case report of membranous nephropathy with clinicopathological features similar to our case.
Highlights
Membranous nephropathy (MN) is one of the most common causes of nephrotic syndrome (NS) in adults [1]
Apparent underlying disease was not found during the 3-year follow-up, and lowdose prednisolone was effective in the treatment of NS
We report an additional case of MN with solitary polyclonal IgA deposition
Summary
Membranous nephropathy (MN) is one of the most common causes of nephrotic syndrome (NS) in adults [1]. Most cases of PMN have circulating IgG4 autoantibodies to the M-type phospholipase A2 receptor (PLA2R) (70%) or antibodies to the thrombospondin type-1 domain-containing 7A (3 – 5%) [1]. Based on these immunological features, PMN is classified as an IgG4 autoimmune disease [2]. A 60-year-old Japanese man was admitted to Honjo Daiichi Hospital due to proteinuria and edema He had been diagnosed with type 2 diabetes. From the above-mentioned pathological findings, the diagnosis of early stage MN with solitary polyclonal IgA deposition was made He was treated with low-dose prednisolone (PSL) (10 mg/day for 8 weeks) in consideration of his history of type 2 diabetes. His urinary protein was 2.1 g/g creatinine, serum total protein 5.8 g/dL, albumin 3.5 g/dL, and creatinine 0.87 mg/dL
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