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      Membranous Glomerulonephritis, Antiphospholipid Syndrome, and Persistent Low C3 Levels Associated with Meningococcal Disease

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          A young male patient with a recent history of meningococcemia was referred to our hospital in his recovery period. He had signs suggesting deep venous thrombosis in the legs but no other abnormalities on physical examination at admission. Laboratory results showed proteinuria (3.1 g/day), prolonged activated partial thromboplastin time (56.3 s), low level of C3c (0.19 g/l), high titers of both IgM (27.04 MPLU/ml) and IgG (74.88 GPLU/ml) anticardiolipin antibodies and recanalized thrombotic changes in the deep veins of the lower extremities on venography. Histopathological diagnosis of the kidney disease was membranous glomerulonephritis. He was started on an angiotensin-converting enzyme inhibitor to reduce proteinuria and an oral anticoagulant to prevent thromboembolic events. Since no reduction in proteinuria was observed at the 10th month of therapy, the angiotensin-converting enzyme inhibitor was discontinued. On his last follow-up, approximately 1.5 years after meningococcemia, he had no complaints and no abnormal findings on physical examination. While both IgM and IgG anticardiolipin antibody titers returned to the normal range, he still had persistent proteinuria and hypocomplementemia.

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          Massive Proteinuria as a Main Manifestation of Primary Antiphospholipid Syndrome

           Y Levy,  J. George,  L Ziporen (1998)
          Renal involvement in antiphospholipid syndrome (APS) is increasingly reported. So far, massive proteinuria as the principal feature of primary APS (PAPS) has not been well documented. We describe 3 patients with PAPS and massiv proteinuria. Renal biopsy was performed in all 3, and features consistent with membranous and focal segmental glomerulopathy were disclosed. These histological lesions were not yet reported in PAPS. We conclude that the spectrum of renal lesions in PAPS is diverse and that it should be considered in the differential diagnosis of patients with massive proteinuria.

            Author and article information

            S. Karger AG
            June 2002
            03 June 2002
            : 91
            : 2
            : 336-338
            Departments of aInternal Medicine and bPathology, Gülhane Military Medical Academy, Etlik, Ankara, and cMilitary Hospital, Sivas, Turkey
            58415 Nephron 2002;91:336–338
            © 2002 S. Karger AG, Basel

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            Figures: 1, References: 9, Pages: 3
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            Short Communication

            Cardiovascular Medicine, Nephrology

            Meningococcal disease, Membranous glomerulonephritis


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