Department of Medicine, University of Iowa, Iowa City, IA, USA.
Am J Transplant. 2012 Jun;12(6):1637-42. doi: 10.1111/j.1600-6143.2011.03957.x. Epub 2012 Mar 5.
Membranous nephropathy is a common cause of adult nephrotic syndrome, with recent evidence suggesting that 70% of idiopathic disease is associated with anti-Phospholipase A(2) receptor autoantibodies. We describe a 63-year-old man with membranous nephropathy who underwent a kidney transplant and developed recurrent membranous nephropathy with fine granular co-localization of Phospholipase A(2) receptor and IgG evident on transplant biopsy on day 6 and elevated circulating levels of serum anti-Phospholipase A(2) receptor autoantibody that declined over time in conjunction with improvement in the serum creatinine and urinary protein. This is a very early case of Phospholipase A(2) receptor-associated recurrent membranous nephropathy with circulating anti-Phospholipase A(2) receptor autoantibody, which supports the emerging evidence that idiopathic membranous nephropathy is an autoimmune disease.
膜性肾病是成人肾病综合征的常见病因，最近的证据表明，70%的特发性疾病与抗磷脂酶 A2 受体自身抗体有关。我们描述了一名 63 岁的男性膜性肾病患者，他接受了肾移植，在移植后第 6 天的移植活检中出现了复发性膜性肾病，伴有磷脂酶 A2 受体和 IgG 的细颗粒共定位，同时循环血清抗磷脂酶 A2 受体自身抗体水平升高，随着血清肌酐和尿蛋白的改善而逐渐下降。这是一例非常早期的磷脂酶 A2 受体相关复发性膜性肾病伴循环抗磷脂酶 A2 受体自身抗体的病例，支持特发性膜性肾病是一种自身免疫性疾病的新证据。
