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Characterization of Membranous Nephropathy with Microspherular Deposits.

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August 2023

Department of Pathology and Laboratory Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA.

Introduction: Membranous nephropathy (MN) is a common cause of adult nephrotic syndrome in the USA. The typical ultrastructural finding is of global uniformly dense subepithelial electron-dense immune complex deposits along glomerular basement membranes. However, early reports described deposits with a unique microspherular substructure.

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Rarely, disorders of lipid metabolism cause nephrotic syndrome with progressive kidney disease. Tangier disease is a rare condition belonging to this family of lipid disorders; however, it is not associated with kidney disease. We report a patient presenting with nephrotic syndrome, leading to the unmasking of Tangier disease.

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It is clinically possible for patients with Alport syndrome (AS) to suffer from poststreptococcal acute glomerulonephritis (PSAGN). However, there is only one report of such a patient, and he had end-stage kidney disease. Here, we describe an 8-year-old male with X-linked AS and chronic kidney disease (CKD) stage G2.

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Article Synopsis
  • A 64-year-old Japanese man developed sepsis and meningitis due to a Streptococcus suis infection after experiencing fever, headache, and deafness.
  • His renal function deteriorated rapidly, requiring temporary hemodialysis, but improved with antimicrobial treatment following a renal biopsy.
  • The case revealed similarities to staphylococcal-related nephritis, including features like mesangial proliferative nephritis and electron-dense deposits, highlighting novel findings in S. suis-associated glomerulonephritis.
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Article Synopsis
  • Primary Sjögren's syndrome (pSS) is an autoimmune disease that causes inflammation in glands like salivary and tear glands, leading to symptoms like dry mouth and eyes, as well as potentially serious extra-glandular complications such as kidney involvement.
  • A case of a 48-year-old Japanese woman with pSS revealed she developed nephrotic syndrome due to glomerulonephritis (GN), which was linked to immune complexes made up of a specific type of IgA (Gd-IgA1).
  • Diagnostic tests showed increased levels of Gd-IgA1 in her serum and the presence of these complexes in her kidneys, suggesting a connection between Gd-IgA1 production in pSS
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