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Syphilis-related Membranous Nephropathy in a 35-year-old Woman
Yuki Nakayama1, Masayuki Yamanouchi1, Hiroki Mizuno1
1Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Kajigaya, Japan.
Abstract:
A 35-year-old woman was admitted for the examination of lower leg edema and proteinuria. A kidney biopsy showed membranous nephropathy (MN) with fine granular deposits of IgG along the glomerular capillary and poor spike formation, differing from primary MN in the presence of positive IgG3 and C1q. Lupus nephritis was excluded because serum complement and anti-dsDNA antibody, anti-Smith antibody, and anti-cardiolipin antibody tests were negative. The serological test for syphilis was positive, as was the Treponema pallidum hemagglutination test. The patient was diagnosed with syphilis, and the proteinuria disappeared with antibiotic treatment. In MN with positive IgG3 and C1q, syphilis nephropathy may be a differential diagnosis.
Insights
Syphilis can cause membranous nephropathy (MN) with specific IgG deposits. Prompt antibiotic treatment resolved proteinuria in a patient with syphilis-associated MN, highlighting its importance in differential diagnosis.
Area of Science:
- Nephrology
- Infectious Diseases
- Immunology
Background:
- Membranous nephropathy (MN) is a common cause of nephrotic syndrome in adults.
- Distinguishing primary MN from secondary causes is crucial for appropriate treatment.
- Syphilis is a systemic infection that can affect multiple organs, including the kidneys.
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