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NDT Plus Advance Access published online on August 24, 2009
NDT Plus, doi:10.1093/ndtplus/sfp112
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

MPO-ANCA crescentic glomerulonephritis complicated by membranous nephropathy: MPO demonstrated in epimembranous deposits

Kei Matsumoto, Hirokazu Honda, Takanori Shibata, Daisuke Sanada, Yukihiro Wada, Eijin Ashikaga, Aki Kuroki, Kozo Kitazawa and Tadao Akizawa

Division of Nephrology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan

Correspondence: Hirokazu Honda; E-mail: hondah{at}med.showa-u.ac.jp


  Abstract

An elderly woman presented with haematuria and proteinuria accompanied by elevated serum myeloperoxidase (MPO)-specific anti-neutrophil cytoplasmic antibodies (MPO-ANCA). A renal biopsy revealed mild mesangial proliferation with fibrocellular crescent formation and a membranous glomerular lesion. Immunofluorescence microscopy using FITC-labelled rabbit anti-human MPO antibodies revealed granular MPO deposition along the glomerular capillary walls (GCW) with a staining profile similar to that of glomerular IgG deposition. The one-year follow-up renal biopsy revealed minimal IgG and undetectable MPO deposition. Both MPO and MPO-ANCA might have been responsible for the IgG immune depositions along the GCW in this patient.

Key Words: membranous glomerulopathy • MPO-ANCA • myeloperoxidase

Received for publication April 23, 2009. Accepted for publication July 29, 2009.


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