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Proliferative glomerulonephritis and primary antiphospholipid syndrome
Abdalla H Abdalla1, Hala K Kfoury, Mohamed Al-Suleiman
1Department of Nephrology, Riyadh Medical Complex, Riyadh, Kingdom of Saudi Arabia.
Saudi Medical Journal
|July 11, 2006
Summary
Primary antiphospholipid syndrome (APLS) can cause proliferative glomerulonephritis (GN) through immune deposits, not just thrombotic microangiopathy. This case highlights a potential link in patients without lupus.
Area of Science:
- Nephrology
- Rheumatology
- Immunology
Background:
- Primary antiphospholipid syndrome (APLS) is an autoimmune disorder.
- The association between APLS and proliferative glomerulonephritis (GN) is not well understood.
- Thrombotic microangiopathy (TMA) is a known renal manifestation of APLS.
Observation:
- A case of biopsy-documented primary APLS with proliferative GN is presented.
- The patient exhibited deep venous thrombosis, nephrotic syndrome, and a history of pregnancy complications.
- Absence of systemic lupus erythematosus (SLE) and TMA was noted.
Findings:
- Lupus anticoagulant was positive, confirming primary APLS diagnosis.
- Renal biopsy revealed membranoproliferative GN.
- The patient had persistent proteinuria but stable renal function over 12 years.
- Immune deposits were identified as the cause of GN, distinct from TMA.
Implications:
- Primary APLS can be associated with immune-mediated proliferative GN, independent of SLE or TMA.
- Further renal biopsies in APLS patients may reveal a higher prevalence of proliferative GN.
- This finding could inform future treatment strategies for APLS-related kidney disease.
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