Fibrillary Glomerulonephritis with Crescentic and Necrotizing Glomerulonephritis and Concurrent Thrombotic Microangiopathy

We present a 77-year-old Caucasian woman who presented with nephrotic-range proteinuria, microhematuria, renal impairment, and extremely elevated blood pressure. She had a long history of well-controlled type 2 diabetes. Renal biopsy revealed fibrillary deposits in the mesangium and glomerular basem...

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Main Authors: Calvin Tsui, Pouneh Dokouhaki, Bhanu Prasad
Format: Article
Language:English
Published: Karger Publishers 2018-08-01
Series:Case Reports in Nephrology and Dialysis
Subjects:
Online Access:https://www.karger.com/Article/FullText/492529
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spelling doaj-793c0fb8c3324ff8ba4a3b7c236680622020-11-25T00:31:00ZengKarger PublishersCase Reports in Nephrology and Dialysis2296-97052018-08-018218219110.1159/000492529492529Fibrillary Glomerulonephritis with Crescentic and Necrotizing Glomerulonephritis and Concurrent Thrombotic MicroangiopathyCalvin TsuiPouneh DokouhakiBhanu PrasadWe present a 77-year-old Caucasian woman who presented with nephrotic-range proteinuria, microhematuria, renal impairment, and extremely elevated blood pressure. She had a long history of well-controlled type 2 diabetes. Renal biopsy revealed fibrillary deposits in the mesangium and glomerular basement membrane consistent with fibrillary glomerulopathy (FGN), with crescentic changes and thrombotic microangiopathy (TMA). We could not identify any radiological, clinical, or laboratory evidence of autoimmune disorders, lymphoproliferative disorders, and malignancy. It was decided not to offer her any immunosuppressive therapy, as she was frail with substantial renal damage on the biopsy. Five months after presentation, she gradually progressed to requiring renal replacement therapy and is currently on maintenance hemodialysis. Crescentic changes in FGN, though rare, have been previously described, but the concurrent presence of TMA has never been previously reported.https://www.karger.com/Article/FullText/492529Fibrillary glomerulonephritisThrombotic microangiopathyCrescentic changes
collection DOAJ
language English
format Article
sources DOAJ
author Calvin Tsui
Pouneh Dokouhaki
Bhanu Prasad
spellingShingle Calvin Tsui
Pouneh Dokouhaki
Bhanu Prasad
Fibrillary Glomerulonephritis with Crescentic and Necrotizing Glomerulonephritis and Concurrent Thrombotic Microangiopathy
Case Reports in Nephrology and Dialysis
Fibrillary glomerulonephritis
Thrombotic microangiopathy
Crescentic changes
author_facet Calvin Tsui
Pouneh Dokouhaki
Bhanu Prasad
author_sort Calvin Tsui
title Fibrillary Glomerulonephritis with Crescentic and Necrotizing Glomerulonephritis and Concurrent Thrombotic Microangiopathy
title_short Fibrillary Glomerulonephritis with Crescentic and Necrotizing Glomerulonephritis and Concurrent Thrombotic Microangiopathy
title_full Fibrillary Glomerulonephritis with Crescentic and Necrotizing Glomerulonephritis and Concurrent Thrombotic Microangiopathy
title_fullStr Fibrillary Glomerulonephritis with Crescentic and Necrotizing Glomerulonephritis and Concurrent Thrombotic Microangiopathy
title_full_unstemmed Fibrillary Glomerulonephritis with Crescentic and Necrotizing Glomerulonephritis and Concurrent Thrombotic Microangiopathy
title_sort fibrillary glomerulonephritis with crescentic and necrotizing glomerulonephritis and concurrent thrombotic microangiopathy
publisher Karger Publishers
series Case Reports in Nephrology and Dialysis
issn 2296-9705
publishDate 2018-08-01
description We present a 77-year-old Caucasian woman who presented with nephrotic-range proteinuria, microhematuria, renal impairment, and extremely elevated blood pressure. She had a long history of well-controlled type 2 diabetes. Renal biopsy revealed fibrillary deposits in the mesangium and glomerular basement membrane consistent with fibrillary glomerulopathy (FGN), with crescentic changes and thrombotic microangiopathy (TMA). We could not identify any radiological, clinical, or laboratory evidence of autoimmune disorders, lymphoproliferative disorders, and malignancy. It was decided not to offer her any immunosuppressive therapy, as she was frail with substantial renal damage on the biopsy. Five months after presentation, she gradually progressed to requiring renal replacement therapy and is currently on maintenance hemodialysis. Crescentic changes in FGN, though rare, have been previously described, but the concurrent presence of TMA has never been previously reported.
topic Fibrillary glomerulonephritis
Thrombotic microangiopathy
Crescentic changes
url https://www.karger.com/Article/FullText/492529
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AT pounehdokouhaki fibrillaryglomerulonephritiswithcrescenticandnecrotizingglomerulonephritisandconcurrentthromboticmicroangiopathy
AT bhanuprasad fibrillaryglomerulonephritiswithcrescenticandnecrotizingglomerulonephritisandconcurrentthromboticmicroangiopathy
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