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April 6, 2021

Diagnose This (April 5, 2021)

ACNA or Anti-GBM

In a patient with these findings, which serological exams results would you be interested to know?

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Answer: This is a case of a PLA2R-positive membranous nephropathy with crescents. Relevant positive serologies included ANCA serologies, anti-GBM, and serum anti-PLA2R. Primary MN with crescents is rare; approximately half of the cases are due to concomitant positive ANCA (most commonly MPO) or anti-GBM. These patients tend to present more often with hematuria and acute kidney injury, and have a higher rate of progression to ESRD than MN without crescents.

https://doi.org/10.1016/j.ekir.2019.07.021

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136355/