Vascular threads and nephron nests: exploring the association between Takayasu arteritis and membranous nephropathy

Q3 Medicine

European journal of case reports in internal medicine Pub Date : 2024-07-02 DOI:10.12890/2024_004557

Sameen Aamer, Anand Rajan, Swati Arora

引用次数: 0

Abstract

Takayasu arteritis (TA) primarily causes ischaemic nephrosclerosis but can occasionally be associated with glomerulopathy. We report a case of a female in her twenties with PLA2-negative, THSD7A-positive membranous nephropathy (MN) refractory to rituximab, who presented with neck pain and new-onset hypertension. Blood work showed elevated inflammatory markers. Imaging of the head and neck revealed focal dilation and irregularity of the vertebral arteries, consistent with TA. The patient was started on treatment with steroids, followed by mycophenolate mofetil, which led to the resolution of symptoms and nephrotic syndrome. This case highlights an uncommon sequence of events, with MN presenting before TA, underscoring the need to consider TA in differentials for patients with MN. Notably, this is the first reported case in a young female, emphasising the need for further understanding of TA-associated glomerular diseases. Additionally, the presence of THSD7A in MN, despite negative malignancy workup, is also noteworthy.

查看原文本刊更多论文

血管线与肾小球巢：探索高安动脉炎与膜性肾病之间的关联

高安动脉炎（TA）主要导致缺血性肾硬化，但偶尔也会伴有肾小球病变。我们报告了一例二十多岁的女性患者，她患有 PLA2 阴性、THSD7A 阳性的膜性肾病（MN），对利妥昔单抗难治，并伴有颈部疼痛和新发高血压。血液检查显示炎症指标升高。头颈部造影显示椎动脉局灶性扩张和不规则，与TA一致。患者开始接受类固醇治疗，随后又接受了霉酚酸酯治疗，症状和肾病综合征得以缓解。本病例强调了一个不常见的事件顺序，即 MN 在 TA 之前出现，强调了在鉴别 MN 患者时考虑 TA 的必要性。值得注意的是，这是首例报告的年轻女性病例，强调了进一步了解与 TA 相关的肾小球疾病的必要性。此外，值得注意的是，尽管恶性肿瘤检查结果呈阴性，但MN患者体内仍存在THSD7A。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European journal of case reports in internal medicine

CiteScore

2.10

自引率

0.00%

发文量

166

审稿时长

8 weeks

期刊介绍： The European Journal of Case Reports in Internal Medicine is an official journal of the European Federation of Internal Medicine (EFIM), representing 35 national societies from 33 European countries. The Journal''s mission is to promote the best medical practice and innovation in the field of acute and general medicine. It also provides a forum for internal medicine doctors where they can share new approaches with the aim of improving diagnostic and clinical skills in this field. EJCRIM welcomes high-quality case reports describing unusual or complex cases that an internist may encounter in everyday practice. The cases should either demonstrate the appropriateness of a diagnostic/therapeutic approach, describe a new procedure or maneuver, or show unusual manifestations of a disease or unexpected reactions. The Journal only accepts and publishes those case reports whose learning points provide new insight and/or contribute to advancing medical knowledge both in terms of diagnostics and therapeutic approaches. Case reports of medical errors, therefore, are also welcome as long as they provide innovative measures on how to prevent them in the current practice (Instructive Errors). The Journal may also consider brief and reasoned reports on issues relevant to the practice of Internal Medicine, as well as Abstracts submitted to the scientific meetings of acknowledged medical societies.