• Internal medicine · Jan 2021

    Case Reports

    Membranous Nephropathy with Proteinase 3-ANCA-associated Vasculitis Successfully Treated with Rituximab.

    • Shun Yoshida, Shunichiro Hanai, Daiki Nakagomi, Kei Kobayashi, Kazuya Takahashi, and Fumihiko Furuya.
    • Third Department of Internal Medicine, University of Yamanashi, Japan.
    • Intern. Med. 2021 Jan 1; 60 (1): 145-150.

    AbstractMembranous nephropathy (MN) with anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (ANCA-GN) is seen infrequently. Previous reports of patients with ANCA-GN with MN showed that the most frequent ANCA subtype was myeloperoxidase-ANCA. We herein present a 73-year-old woman with scleritis, hematuria, proteinuria, and positive serum proteinase 3 (PR3)-ANCA. She underwent a renal biopsy and was diagnosed with MN and ANCA-GN. Immunofluorescence staining for PR3 colocalized with IgG along the glomerular basement membrane were observed. Oral prednisolone and intravenous rituximab therapy immediately improved her symptoms and urinalysis abnormalities. PR3-ANCA may be involved in the pathogenesis of MN via the formation of immune complexes.

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