Membranous nephropathy (bubbling appearance and spike formation) without immunoglobulin deposition in a patient with systemic lupus erythematosus

Clin Exp Nephrol. 2008 Dec;12(6):475-8. doi: 10.1007/s10157-008-0096-8. Epub 2008 Oct 7.

Abstract

A 53-year-old Japanese man with systemic lupus erythematosus developed proteinuria and hematuria after a urinary stone episode. A light microscopic study of a kidney biopsy specimen demonstrated a bubbling appearance and spike formation of the basement membrane. Immunofluorescent studies revealed that there were no significant depositions of immunoglobulins, such as IgG (-), IgA (-), IgM (+/-), kappa light chain (+/-), lambda light chain (+/-), or C3 (-) in the glomerular capillary wall, though C1q was present as one-plus positive staining in mesangial areas. Electron microscopic studies showed that the thickness of the basement membrane varied from thin to thick without electron dense deposits, and that the cellular components of the podocyte were irregularly present in the basement membrane. Urinary protein decreased after the usage of prednisolone and mizoribine; however, proteinuria aggravated after an episode of urinary stone during the same treatment.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Glomerular Basement Membrane / pathology
  • Glomerular Basement Membrane / ultrastructure
  • Glomerulonephritis, Membranous / immunology
  • Glomerulonephritis, Membranous / pathology*
  • Humans
  • Immunoglobulins / analysis*
  • Lupus Erythematosus, Systemic / immunology
  • Lupus Erythematosus, Systemic / pathology*
  • Male
  • Microscopy, Electron
  • Middle Aged
  • Podocytes / pathology

Substances

  • Immunoglobulins