Takayasu's arteritis and secondary membranous nephropathy: an exceptional association

BMJ Case Rep. 2021 Mar 1;14(3):e237945. doi: 10.1136/bcr-2020-237945.

Abstract

The association between Takayasu's arteritis and membranous nephropathy is uncommon. We present the case of a 46-year-old man with Takayasu's arteritis treated over 10 years by a multidisciplinary medical team. He had an atrophic left kidney due to arterial stenosis, with a basal creatinine of 1.59 mg/dL (140.55 µmol/l). Three years ago, he presented with full nephrotic syndrome, uncontrolled blood pressure, creatinine increases to 4.5 mg/dL (basal: 1.59 mg/dL), severe hypoalbuminaemia (1.4 g/dL) and albuminuria of 24.6 g per day. He underwent percutaneous biopsy of the right kidney that showed membranous nephropathy with negative PLA2R1 and positive IgG 1, 3 and 4 subclasses. After therapy with oral prednisone and cyclophosphamide, the patient's kidney function improved, without recurrence of disease after 3 years of follow-up. Here, we present this extremely uncommon association of Takayasu's arteritis and membranous nephropathy.

Keywords: chronic renal failure; nephrotic syndrome; vasculitis.

Publication types

  • Case Reports

MeSH terms

  • Cyclophosphamide / therapeutic use
  • Glomerulonephritis, Membranous* / complications
  • Glomerulonephritis, Membranous* / diagnosis
  • Glomerulonephritis, Membranous* / drug therapy
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Prednisone / therapeutic use
  • Receptors, Phospholipase A2
  • Takayasu Arteritis* / complications
  • Takayasu Arteritis* / diagnosis
  • Takayasu Arteritis* / drug therapy

Substances

  • PLA2R1 protein, human
  • Receptors, Phospholipase A2
  • Cyclophosphamide
  • Prednisone