Autosomal Dominant Polycystic Kidney Disease With Idiopathic Membranous Nephropathy: An Unusual Association?

Antonio Granata, Lidia Puzzo, Fulvio Floccari, Carmelo Erio Fiore

Abstract


          Autosomal dominant polycystic kidney disease (ADPKD) is usually characterized by proteinuria less than 1 g/24 hours and only anecdotal cases of associated nephrotic syndrome have been reported. We report another case of ADPKD with nephrotic syndrome, where histological examination showed features of membranous glomerulonephritis. Serologic tests for hepatitis B surface antigen and anti-hepatitis C antibodies were negative. Antinuclear antibody and anti-neutrophil cytoplasmic antibody were negative. Serum complement fraction, C3 and C4, were within normal range. Abdominal ultrasound examination showed both enlarged liver and kidneys, both with multiple cysts of varying sizes. Nevertheless renal parenchyma between cysts was not yet widely interested. Family history revealed ADPKD affecting the mother. Considering nephrotic proteinuria, a percutaneous biopsy was performed, and a diagnosis of idiopathic membranous nephropathy associated with ADPKD was made. Our patient was managed with salt restriction, diuretics and antihypertensive drugs (ACE-I and ARB) and started therapy according to Ponticelli's Protocol. At 12 week follow up proteinuria dropped to less than 1 g/24 hours, with normalization of renal function. Our case confirmed the importance of kidney biopsy even in patients with ADPKD and nephrotic syndrome, in order to demonstrate any coexisting glomerular disease, make an accurate diagnosis and plan appropriate treatment.




doi:10.4021/jmc144w


Keywords


Nephrotic syndrome; Autosomal dominant polycystic kidney disease; Idiopathic membranous nephropathy; Kidney biopsy

Full Text: HTML PDF
 

Browse  Journals  

     

Journal of clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics

World Journal of Oncology

Gastroenterology Research

Journal of Hematology

Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity

Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research

Journal of Neurology Research

International Journal of Clinical Pediatrics

 

 

 

 

 

Journal of Medical Cases, monthly, ISSN 1923-4155 (print), 1923-4163 (online), published by Elmer Press Inc.            
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)


This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.journalmc.org   editorial contact: editor@journalmc.org
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.