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Our study attempted to further understand the clinical and pathological characteristics of cases with lupus-like nephritis (LLN).
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It remains unclear how to classify or treat these patients. Although a minority eventually develops SLE, many do not. The majority are negative for markers of primary MGN (PLA2R, THSD7A, and NELL1) and show features suggestive of secondary MGN.īackground: A subset of patients without overt systemic lupus erythematosus (SLE) present with biopsy findings typically seen in lupus nephritis (LN). MGN with subepithelial microspherular structures is frequently associated with an underlying autoimmune disease. 40% were idiopathic and negative for PLA2R, NELL1, and THSD7A. One additional case had antiphospholipid syndrome and showed lupus-like features on biopsy. Two SLE cases had concomitant rheumatoid arthritis and Sjogren's syndrome. 50% had an autoimmune disorder, of which 80% were SLE. The majority were Caucasian (80%) with a mean age of 51.3 (☑2.9) years.
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To further understand the significance of subepithelial microspherular deposits, we retrospectively identified native kidney biopsies from 10 patients diagnosed as MGN with subepithelial microspherular structures identified by ultrastructural examination at the University of Rochester Medical Center (URMC) during an 11-year period. The paucity of available studies shows a strong association with underlying autoimmune disease. Rare cases of membranous glomerulopathy (MGN) with subepithelial deposits consisting of microspherular structures identified by electron microscopy have been described in the literature as either MGN with spherules or podocyte infolding glomerulopathy (PIG).