A Rare Adult Case with Diffuse Segmental Membranous Glomerulonephritis

Yoshihide Fujigaki; Yoshifuru Tamura; Shigeru Shibata; Fukuo Kondo; Takamasa Iwakura; Kenichiro Kojima; Yutaka Yamaguchi; Shunya Uchida

doi:10.2169/internalmedicine.56.8298

CASE REPORTS

A Rare Adult Case with Diffuse Segmental Membranous Glomerulonephritis

Yoshihide Fujigaki, Yoshifuru Tamura, Shigeru Shibata, Fukuo Kondo, Takamasa Iwakura, Kenichiro Kojima, Yutaka Yamaguchi, Shunya Uchida

Author information

Yoshihide Fujigaki
Department of Internal Medicine, Teikyo University School of Medicine, Japan
Central Laboratory, Teikyo University School of Medicine, Japan
Yoshifuru Tamura
Department of Internal Medicine, Teikyo University School of Medicine, Japan
Shigeru Shibata
Department of Internal Medicine, Teikyo University School of Medicine, Japan
Fukuo Kondo
Department of Pathology, Teikyo University School of Medicine, Japan
Takamasa Iwakura
Internal Medicine I, Division of Nephrology, Hamamatsu University School of Medicine, Japan
Kenichiro Kojima
Division of Nephrology, Ageo Central General Hospital, Japan
Yutaka Yamaguchi
Department of Pathology, Teikyo University School of Medicine, Japan
Shunya Uchida
Department of Internal Medicine, Teikyo University School of Medicine, Japan

Keywords: adult, IgG subclass, membranous glomerulonephritis, renal pathology, secondary membranous glomerulonephritis

JOURNAL OPEN ACCESS

2017 Volume 56 Issue 13 Pages 1691-1695

DOI https://doi.org/10.2169/internalmedicine.56.8298

Details

Abstract

A 71-year-old man with hypertension and diabetes mellitus presented with proteinuria. Laboratory data showed proteinuria of 3.1 g/g creatinine, serum albumin of 3.5 g/dL and serum creatinine of 1.03 mg/dL without autoantibodies. A renal biopsy revealed segmental granular IgG depositions on glomerular capillary walls. Electron microscopy showed segmentally subepithelial, intramembranous and mesangial deposits. Diffuse segmental membranous glomerulonephritis (MGN) was diagnosed with only IgG1 deposition and without M-type phospholipase A2 receptor or thrombospondin type-1 domain-containing 7A staining, suggesting secondary MGN with an unknown target antigen in immune deposits. Physicians should keep in mind the existence of segmental MGN to better understand the clinicopathological characteristics.

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