Spontaneous Remission Of Thrombospondin Type-1 Domain-containing-associated Membranous Nephropathy
Watanabe, S., Suzuki, T., Han, W., Nakata, M., Koitabashi, K., Ichikawa, D., Kamijo-Ikemori, A., Koike, J., & Shibagaki, Y. (2021). Spontaneous Remission of Thrombospondin Type-1 Domain-Containing-Associated Membranous Nephropathy. Internal medicine (Tokyo, Japan), 60(19), 3125–3128. https://doi.org/10.2169/internalmedicine.6413-20
View Original Source →Abstract
Membranous nephropathy often achieves spontaneous remission. However, there are scarce reports of spontaneous remission of thrombospondin type-1 domain-containing 7A (THSD7A)-associated membranous nephropathy. A 64-year-old female presented with nephrotic syndrome and edema of the lower extremities. We diagnosed membranous nephropathy by kidney biopsy and confirmed positive THSD7A on immunofluorescence using frozen sections; serum THSD7A antibodies were also detected. Thirty-four months after the initial diagnosis, she achieved a spontaneous complete remission without immunosuppressive therapy. With the complete remission, no serum THSD7A levels were detected. In this study, we describe serial examinations of kidney biopsies and serum THSD7A antibodies.
Case Details
Disease Location
Kidney
Personal Characteristics
64-year-old female. History of cerebral hemorrhage and hypertension
Clinical Characteristics
3-week history of lower-extremity edema. A kidney biopsy was performed. Moderate arteriolosclerosis was present. Immunofluorescence (if) staining revealed diffuse positive results for IGG at the periphery and showed strong positive staining for thsd7a. Electron microscopy (em) revealed subepithelial electron-dense deposits in the glomeruli, suggesting a diagnosis of membranous nephropathy (mn), stage ii. One year later, the patient was again admitted for enteritis due to yersinia enterocolitica; her proteinuria had slightly increased, and a second kidney biopsy was performed. Em suggested mn, stage iii, with intramembranous dense and lucent deposits
Remission Characteristics
Thirty four months after the onset of symptoms, the patient has achieved complete remission, her serum thsd7a antibody levels decreased
Treatment & Mechanisms
Clinical Treatment
Biopsy