Not all that is 'full house' is systemic lupus erythematosus: a case of membranous nephropathy due to syphilis infection.

Autor:	Scaperotti MM; Rheumatology, MedStar Georgetown University Hospital, Washington, DC, USA mscaperotti@gmail.com., Kwon D; Pathology, MedStar Georgetown University Hospital, Washington, DC, USA., Kallakury BV; Pathology, MedStar Georgetown University Hospital, Washington, DC, USA., Steen V; Rheumatology, MedStar Georgetown University Hospital, Washington, DC, USA.
Jazyk:	angličtina
Zdroj:	BMJ case reports [BMJ Case Rep] 2021 Aug 19; Vol. 14 (8). Date of Electronic Publication: 2021 Aug 19.
DOI:	10.1136/bcr-2021-244466
Abstrakt:	We describe an unusual case of membranous nephropathy precipitated by syphilis infection in a patient without systemic lupus erythematosus (SLE). A previously healthy 20-year-old man presented with leg and facial swelling. Laboratory investigation revealed nephrotic range proteinuria, acute kidney injury, hypocomplementaemia and a highly positive rapid plasma reagin. Kidney biopsy showed membranous nephropathy with 'full-house' immunofluorescence (IgG, IgA, IgM, C1q and C3), mimicking lupus nephritis class Vb. However, the patient had no features of SLE and had negative antinuclear and anti-double-stranded DNA antibodies. He was treated with high-dose methylprednisolone and mycophenolate mofetil for lupus nephritis and with penicillin for syphilis. After 2 months of therapy, his proteinuria resolved, and his renal function and C4 level normalised. This case illustrates that syphilis infection can be a mimicker of lupus nephritis. A literature review suggests that ful-house nephropathy may occur independently of lupus nephritis and may or may not develop into SLE. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu