Concurrence of Membranous Glomerulonephritis and Pulmonary Alveolar Proteinosis.
10.3904/kjm.2014.87.2.215
- Author:
Bongsoo PARK
1
;
Yang Wook KIM
;
Hyunkuk KIM
;
Taehoon NO
;
Mingyo SEO
;
Yeon Mee KIM
;
Kyubok JIN
Author Information
1. Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea. mdjin922@gmail.com
- Publication Type:Case Report
- Keywords:
Glomerulonephritis, membranous;
Pulmonary alveolar proteinosis
- MeSH:
Adult;
Biopsy;
Diagnosis;
Edema;
Glomerulonephritis, Membranous*;
Humans;
Kidney;
Leg;
Lung;
Lung Diseases;
Lymphocytes;
Microscopy, Electron;
Middle Aged;
Nephrotic Syndrome;
Neutrophils;
Pulmonary Alveolar Proteinosis*;
Steroids;
Therapeutic Irrigation;
Thorax
- From:Korean Journal of Medicine
2014;87(2):215-218
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Membranous glomerulonephritis is one of the most common causes of nephrotic syndrome in adults. Pulmonary alveolar proteinosis (PAP) is a rare lung disease in which abnormal accumulation of surfactant occurs within the alveoli. We describe a 61-year-old man with concurrent membranous glomerulonephritis and PAP, which is very rare; both are pathophysiologically related to an abnormal immune response. A patient came to hospital with leg edema but no respiratory symptoms. Chest X-ray and CT showed classical PAP findings, which are ground-glass opacities with interlobular septal thickening, in both lung fields. A bubbly whitish secretion retrieved via broncho-alveolar lavage showed neutrophils and lymphocytes as well as Periodic acid-Schiff-positive proteinaceous materials. A kidney biopsy revealed findings of membranous glomerulonephritis with irregular subepithelial deposits by electron microscopy. At 1 year after diagnosis, the membranous glomerulonephritis was well under control with steroids and mycophenolate mofetil but PAP became aggravated gradually and whole-lung lavage was needed.
