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The Korean Journal of Pathology 2005;39(4): 278-283.
Combined IgA Nephropathy and Membranous Glomerulonephritis : A Report of Six Cases.
Ji Han Jung, Yeong Jin Choi, Yong Soo Kim, Yoon Sik Chang, Byung Kee Bang, Sang In Shim, Chang Suk Kang
1Departments of Clinical Pathology, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea. dyjchoi@catholic.ac.kr
2Departments of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea.
ABSTRACT
IgA nephropathy (IgAN) and membranous glomerulonephritis (MGN) are common in adults. However, it is unlikely that these two distinct glomerulonephrites coexist in a renal biopsy. Here, we report clinical and pathological data of six patients with concomitant existence of IgAN and MGN in renal biopsy specimens from 1990 to 2004. Five patients were male and one was female, and their ages ranged from 29 to 71 years. Four patients had microscopic hematuria, five had nephrotic range proteinuria, three had hepatitis B virus infections, three had rheumatoid factors, one had antinuclear antibodies. Two cases were developed after kidney transplant. Immunofluorescence microscopy showed characteristic findings of mesangial IgA deposits and granular IgG deposits on the capillary walls. These were confirmed by electron microscopic findings of immune-type electron-dense deposits in the mesangium and subepithelial capillary basement membranes. The pathogenesis and prognosis of the patients are discussed in this report.
Key Words: IgA nephropathy; Membranous glomerulonephritis; Hepatitis B virus; Rheumatoid factor