Kidney Biopsy Teaching CaseAn Uncommon Cause of Membranous Glomerulonephritis
Section snippets
Clinical History and Initial Laboratory Studies
A previously healthy 18-year-old African American woman presented with nausea and vomiting to Mount Carmel East Hospital, Columbus, OH, in May 2008. She had been evaluated 2 weeks before her admission for fatigue and shortness of breath, at which time she was found to be profoundly anemic, with a hemoglobin level of 4.7 g/dL (47 g/L; presumably because of heavy gynecological bleeding, for which she had been prescribed intramuscular progesterone). Two units of packed red blood cells were
Discussion
Syphilis is a well-known cause of secondary MGN,3, 4, 5, 6 but is not commonly diagnosed in the United States. According to data from the 2001 to 2004 National Health and Nutrition Examination Surveys, US population-based estimates of syphilis seroprevalence show overall seroreactivity of 0.71% in the general population (aged 18 to 49 years), with substantial disparity by race/ethnicity.7, 8, 9
In a patient with a known history of syphilis (even latent syphilis) who develops MGN,6 the
Acknowledgements
Support: None.
Financial Disclosure: None.
References (23)
- et al.
[Rash and nephrotic syndrome: Consider syphilis]
Presse Med
(2005) Prognosis and treatment of membranous glomerulopathyNephrology Forum
Kidney Int
(1986)- et al.
Rapidly progressive glomerulonephritis in a patient with syphilisIdentification of antitreponemal antibody and treponemal antigen in renal tissue
Am J Med
(1984) - et al.
Antiphospholipid antibodies, antiphospholipid syndrome and infections
Autoimmun Rev
(2008) - et al.
Distribution of glomerular IgG subclass deposits in malignancy-associated membranous nephropathy
Nephrol Dial Transplant
(2004) - et al.
Glomerular and serum IgG subclasses in diffuse proliferative lupus nephritis, membranous lupus nephritis, and idiopathic membranous nephropathy
Intern Med
(2002) - et al.
Secondary syphilis and nephrotic syndrome
J Am Soc Nephrol
(1993) - et al.
The variety of clinical and histopathological presentations of glomerulonephritis associated with latent syphilis
Int Urol Nephrol
(1992) - et al.
Incidence of glomerulonephritis in congenital syphilis
Clin Nephrol
(1983) - et al.
Prevalence of syphilis seroreactivity in the United States: Data from the National Health and Nutrition Examination Surveys (NHANES) 2001-2004
Sex Transm Dis
(2008)
Race and the prevalence of syphilis seroreactivity in the United States population: A national sero-epidemiologic study
Am J Public Health
Cited by (14)
Membranous glomerulonephritis secondary to syphilis
2015, Brazilian Journal of Infectious DiseasesDiagnostic Pathology: Kidney Diseases: A volume in Diagnostic Pathology
2015, Diagnostic Pathology: Kidney DiseasesMembranous Nephropathy in Syphilis is Associated with Neuron-Derived Neurotrophic Factor
2023, Journal of the American Society of NephrologyA 16-month-old boy with nephrotic syndrome of apparent idiopathic origin: Answer
2023, Pediatric NephrologyA rare cause of full-house membranous glomerulopathy in an infant: Answers
2022, Pediatric NephrologyIgG4-Related Tubulointerstitial Kidney Disease
2022, Tubulointerstitial Nephritis
Originally published online as doi:10.1053/j.ajkd.2009.06.015 on July 31, 2009.