Background: The concomitant presence of idiopathic membranous nephropathy and IgA nephropathy is rare.\nHere, we report 9 cases of phospholipase-A2-receptor (PLA2R) positive idiopathic membranous nephritis combined\nwith IgA nephropathy, while reviewing publications regarding the pathological characteristics of this\nglomerolonephritis complication.\nCase presentation: Nine cases of renal biopsy tissues were retrospectively reviewed, including the clinicopathological\nfeatures, the results of the immunofluorescence assays, and the electron microscopic examination. The patients mainly\npresented proteinuria and microscopic hematuria, and the serum anti-PLA2R was detected as positive in all of\nthe patients. Histologically, a wide thickening of the glomerular basement membrane was observed in each of\nthe 9 cases. Additionally, there existed mild hyperplasia in the mesangial cell and the matrix of the mesangial\narea. Immunofluorescence assays showed prominent glomerular granular staining on the glomerular capillary\nloops for IgG (++/+++), IgG4 (++/++++), and PLA2R (+/++). In addition, moderate IgA positive stains were\nfocally or sparsely limited to the mesangial areas. Electron microscopy revealed subepithelial and mesangial\nelectron-dense deposits.\nConclusions: The results from the case analyses indicated that idiopathic membranous nephropathy combined\nwith IgA nephropathy possess the clinicopathological features found in both components. It is suggested that\nserum anti-PLA2R and tissue PLA2R are important biomarkers that can assist in the diagnosis of idiopathic\nmembranous nephropathy associated with IgA nephropathy
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