Mohammad Ibrahim Walaa Hosny, Aly Mostafa Gaafar, Abdo Marwa Kamal, Ismail Wesam
Internal Medicine Department-Nephrology Unit, Assiut University Hospital, Egypt.
Department of Nephrology, University of Heidelberg, Heidelberg, Germany.
Indian J Nephrol. 2019 Mar-Apr;29(2):140-142. doi: 10.4103/ijn.IJN_7_18.
The association of bilharziasis with membranous nephropathy (MN) has long been debated. The relatively recent use of antibodies against the M-type phospholipase A2 receptor (PLA2R) has been proposed as a valuable tool to discriminate the idiopathic from secondary MNs. Anti-PLA2R antibodies are found in sera from about 70% of iMN patients, in contrast to patients with secondary MN, in whom serum anti-PLA2R antibodies could not be detected. In the current case report, we detected anti-PLA2R antibodies both in serum and renal biopsy from a patient with MN associated with . This finding confirms the idiopathic nature of the MN and excludes schistosomiasis as the triggering agent of MN. After treating bilharziasis, Ponticelli regimen was initiated without a significant improvement.
血吸虫病与膜性肾病(MN)之间的关联长期以来一直存在争议。相对较新的针对M型磷脂酶A2受体(PLA2R)的抗体已被提议作为区分特发性MN和继发性MN的有价值工具。约70%的特发性MN患者血清中可检测到抗PLA2R抗体,而继发性MN患者血清中则检测不到抗PLA2R抗体。在本病例报告中,我们在一名与……相关的MN患者的血清和肾活检中均检测到了抗PLA2R抗体。这一发现证实了MN的特发性本质,并排除了血吸虫病作为MN的触发因素。在治疗血吸虫病后,开始采用庞蒂切利方案,但病情并无显著改善。