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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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 |
work_keys_str_mv |
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