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

Olusola Sogbein, Tina Kochar, Marjan Afrouzian
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引用次数: 0

Abstract

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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表位扩散:联合膜性狼疮性肾炎和抗gbm疾病的潜在机制?
与抗gbm抗体相关的膜性狼疮肾炎是一种罕见的实体,特别是在血清学上ANA和抗dsdna阴性但补体水平正常的狼疮肾炎患者中。我们报告了一个不寻常的病例,患者最初诊断为抗gbm疾病,其重复活检显示局灶性增生性和膜性狼疮性肾炎(III + V)。第一次活检显示颗粒状线状,第二次活检在内皮下、上皮和系膜区发现多个电子致密沉积物,并伴有足细胞消失。实验研究表明,观察到的顺序组织病理学转变可能反映了免疫重排和表位扩散的作用。
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来源期刊
Case Reports in Nephrology
Case Reports in Nephrology Medicine-Nephrology
CiteScore
1.70
自引率
0.00%
发文量
32
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