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Syphilis as the great mimicker: A case of full-house pattern membranous nephropathy
Shu Ling Fan1, Anthony Landgren2, Irene Ruderman1
1Department of Nephrology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Abstract:
Syphilis is a known cause of membranous nephropathy. We describe a case of a patient presenting with nephrotic syndrome whose renal biopsy demonstrated a 'full house' immunohistochemical pattern with positive IgG, IgM, C1q, IgA, C3c, and C4d staining. He was treated with immunosuppressive agents for minimal change nephropathy and subsequently class V lupus nephritis, before syphilis infection was confirmed. Following treatment with a single dose of intramuscular benzathine penicillin there was complete and rapid resolution of nephrotic syndrome. With progressive rising incidence in the western world, syphilis is an important and under-recognised differential diagnosis in cases of nephrotic syndrome.
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