Imperial College London
Alternate

PROFESSOR H. TERENCE COOK

Faculty of Medicine, Department of Immunology and Inflammation

Emeritus Professor
 
 
 
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Contact

 

+44 (0)20 3313 2009t.h.cook

 
 
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Assistant

 

Miss Claudia Rocchi +44 (0)20 3313 2315

 
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Location

 

9N9Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Nikolopoulou:2019:10.1016/j.ekir.2019.07.021,
author = {Nikolopoulou, A and Huang-Doran, I and McAdoo, SP and Griffith, ME and HT, C and Pusey, CD},
doi = {10.1016/j.ekir.2019.07.021},
journal = {Kidney International Reports},
pages = {1577--1584},
title = {Membranous glomerulonephritis with crescents},
url = {http://dx.doi.org/10.1016/j.ekir.2019.07.021},
volume = {4},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundMembranous glomerulonephritis (MGN) is rarely associated with necrotising and crescentic glomerulonephritis (NCGN).MethodsWe report the clinical and pathological findings in 15 patients with MGN and NCGN associated with ANCA, anti-GBM or anti-PLA2R antibodies.ResultsThe cohort consisted of 15 patients: 7 males and 8 females with a median age of 63 years (range 18-79). In 12/15 patients MGN and NCGN were diagnosed at the time of the biopsy and in 3 cases MGN predated the NCGN. ANCA was positive in 7 cases (6 MPO-ANCA and 1 PR3 –ANCA), anti-GBM antibodies were detected in 5 cases and anti-PLA2R antibodies were found in 2 cases. One case was negative for all antibodies. Microscopic haematuria was present in all but one patient who was anuric and median urinary protein/creatinine ratio (uPCR) was 819.5mg/mmol [range 88-5600]. Pathologic evaluation revealed MGN and NCGN with crescents involving 28% of glomeruli (median, range 5-100%). Follow up was available for all 15 patients; all were treated with steroids; 10 with cyclophosphamide and 6 also received rituximab. At a median follow up of 72 months, 9 had stabilisation or improvement of renal function, 6 patients progressed to ESRD and 4 died during the follow up period.ConclusionsMGN with crescents associated with ANCA or anti-GBM antibodies is a rare dual glomerulopathy. Patients present with heavy proteinuria, microscopic haematuria and acute kidney injury and should be treated for a rapidly progressive glomerulonephritis. Prognosis is variable and 40% of patients progress to ESRD.
AU  - Nikolopoulou,A
AU  - Huang-Doran,I
AU  - McAdoo,SP
AU  - Griffith,ME
AU  - HT,C
AU  - Pusey,CD
DO  - 10.1016/j.ekir.2019.07.021
EP  - 1584
PY  - 2019///
SN  - 2468-0249
SP  - 1577
TI  - Membranous glomerulonephritis with crescents
T2  - Kidney International Reports
UR  - http://dx.doi.org/10.1016/j.ekir.2019.07.021
UR  - https://www.sciencedirect.com/science/article/pii/S2468024919314421?via%3Dihub
UR  - http://hdl.handle.net/10044/1/72783
VL  - 4
ER  -
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