Membranous
nephropathy (MN) is the most common cause of primary nephrotic syndrome in
nondiabetic, Caucasian adults, accounting for more than one third of cases.
Most of patients with MN have preserved renal function at the time of
presentation. Renal failure usually develops gradually in patients with MN and
only rarely is complicated by acute kidney injury.
Pauci-immune necrotizing and
crescentic glomerulonephritis (PNCGN) typically present with rapidly
progressive glomerulonephritis (RPGN). Coexistent MN and PNCGN is a rare
occurrence. We report a case of both MPO- and PR3-ANCA associated NCGN with
membranous nephropathy that presented as rapidly progressiveglomerulonephritis.
Case
Presentation:
A
46-year-old Caucasian woman presented to emergency department with nausea,
vomiting and weight loss. Medical history was remarkable for gastroesophageal
reflux disease (GERD), fibromyalgia and depression. She noticed poor appetite
and 40-pound weight loss over 2 months. Patient denied any recent history of
upper respiratory tract infection, or skin infection. She was taking 4,800 mg
of ibuprofen per day and no other medications. Read more.....................
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