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Dermatomyositis with membranous nephropathy
A Soylu1, S Kavukçu, M Türkmen
1Department of Pediatrics, Dokuz Eylŭl University Faculty of Medicine, Izmir, Turkey.
Abstract:
Dermatomyositis is the connective tissue disease with the least renal involvement. Although some renal findings like proteinuria, hematuria, pyuria, progressive renal insufficiency, and glomerular and tubular calcium deposits with arteriolar fibrosis have been described, glomerulonephritides have rarely been associated with dermatomyositis, especially in childhood cases. We describe a 10-year old boy with the clinical picture of dermatomyositis who underwent renal biopsy due to microscopic hematuria demonstrating membranous glomerulonephritis with Clq deposition. Children with "full-house" membranous glomerulonephritis with deposition of Clq and the other immunoglobulins have been reported to present in the future with the clinical findings of systemic lupus erythematosus. However, laboratory evaluation of our patient for systemic lupus erythematosus was negative at the present time. Thus, we think this case should be followed up closely with special attention to the possible clinical and laboratory findings of systemic lupus erythematosus.
Insights
Dermatomyositis rarely affects kidneys, but a 10-year-old boy developed membranous glomerulonephritis. This case highlights the need for monitoring potential systemic lupus erythematosus development.
Area of Science:
- Nephrology
- Rheumatology
- Pediatric Rheumatology
Background:
- Dermatomyositis is a connective tissue disease with typically minimal renal involvement.
- Glomerulonephritis is an uncommon complication, particularly in pediatric dermatomyositis cases.
- Previous reports link pediatric "full-house" membranous glomerulonephritis to future systemic lupus erythematosus.
Observation:
- A 10-year-old boy presented with clinical features of dermatomyositis.
- Renal biopsy was performed due to microscopic hematuria.
- The biopsy revealed membranous glomerulonephritis with complement C1q deposition.
Findings:
- The patient exhibited membranous glomerulonephritis with C1q deposition, a rare finding in dermatomyositis.
- Initial laboratory tests for systemic lupus erythematosus were negative.
- The specific pattern of glomerulonephritis suggests a potential future risk.
Implications:
- This case underscores the importance of renal surveillance in pediatric dermatomyositis.
- Close follow-up is crucial to detect early signs of systemic lupus erythematosus.
- Understanding these associations can improve diagnostic and management strategies for autoimmune diseases.