This is the story of a 64 year old male mason with past medical history notable for hypertension and hyperlipidemia who was referred to me for evaluation of proteinuria. The patient noted onset of lower extremity edema nine…
Take-home points from Mayo Clinic’s Fernando Fervenza’s excellent Renal Grand Rounds this morning, in which he addresses the potential use of rituximab as a treatment for membranous nephropathy: -the “rule of thirds” that we learn about membranous nephropathy (e.g.,…
Although the majority of membranous nephropathy falls under the “idiopathic” category, there are a variety of causes of secondary membranous nephropathy. It is quite important to eliminate these entities as possible diagnoses, as the treatment for secondary membranous…
Keeping with our recent theme of “numerical rules in Nephrology”, let’s briefly discuss the “Rule of Thirds” for Membranous Nephropathy. The “Rule of Thirds” is frequently taught in medical school and a useful way of thinking about the…
A landmark paper on membranous nephropathy was published by Beck et al in the most recent issue of NEJM. Ultimately we will have to see if the finding is reproducible, but based on the data presented this represents…
Clinical trials evaluating the efficacy of various therapies of membranous nephropathy is a tricky business, given the natural history of the disease: because about 1/3 of patients spontaneously remit, it is often difficult to say that a patient’s…
I went to a very memorable talk today at our Renal Grand Rounds during which fairly convincing data was presented that identifies the long-sought-after antigen which causes membranous nephropathy–still the most common cause of adult-onset nephrotic syndrome in…
When one is just beginning as a nephrology fellow, it may seem as if all the major glomerular diseases (e.g., membranous nephropathy, FSGS, lupus, etc) are all treated with the same protocols and same immunosuppressive agents: steroids, Cytoxan,…
Electron microscopy of biopsy specimens from patients with membranous nephropathy demonstrate subepithelial deposits, leading to the hypothesis that immune complexes form in situ against antigens that are present on the podocyte foot process plasma membrane. Perhaps the strongest…
