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Membranous nephropathy with lupus-like pattern in a patient with HIV and multicentric Castleman disease

Revista Colombiana de Nefrologia, ISSN: 2500-5006, Vol: 11, Issue: 2
2024
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Article Description

Introduction: Post-surgical rhabdomyolysis is frequently a multifactorial pathology, influenced by predisposing elements directly related to the patient, the surgical process, and drugs. A rare case of multifactorial postsurgical RML is presented in an elderly male patient, considered as risk factors, who required RRT and therefore, it increased hospitalization´s days. Purpose: Post-surgical rhabdomyolysis is frequently a multifactorial pathology, influenced by predisposing elements directly related to the patient, the surgical process, and drugs. A rare case of multifactorial postsurgical RML is presented in an elderly male patient, considered as risk factors, who required RRT and therefore, it increased hospitalization´s days. Case presentation: Masculine of 32 years with prior history of HIV infection undergoing treatment with tenofovir, emtricitabine and efavirenz, along with Kaposi’s sarcoma with skin involvement who presents at the emergency department with oedematous syndrome and neck lymph node enlargement. Multicentric Castleman disease was diagnosed upon clinical, biochemical, and histopathological findings. The patient did not present with stigmata of autoimmune disease and had a presenting serum creatinine of 3.04 mg/dl (baseline serum creatinine of 0.88 mg/dl). Other laboratory investigations included an urinalysis with microscopic haematuria and proteinuria, a renal and urinary tract ultrasound without gross alterations and a 24-hour urine recollection with 16.5 grams of proteinuria. He also had hypoalbuminemia (1.6 g/dl). Altogether, criteria for nephrotic syndrome were fulfilled. We also found normal serum complement, serum protein electrophoresis with polyclonal hypergammaglobulinemia and an autoimmune panel with low positive (1 in 80 dilutions) antinuclear antibodies with cytoplasmatic pattern along with proteinase-3 positive antibodies. Myeloperoxidase antibodies were negative. Upon these results we obtained a kidney biopsy compatible with membranous glomerulonephritis, with immunofluorescence compatible with a full-house pattern. A diagnosis of membranous nephropathy with lupus-like pattern Post-surgical rhabdomyolysis is frequently a multifactorial pathology, influenced by predisposing elements directly related to the patient, the surgical process, and drugs. A rare case of multifactorial postsurgical RML is presented in an elderly male patient, considered as risk factors, who required RRT and therefore, it increased hospitalization´s days. Discussion and conclusion: Post-surgical rhabdomyolysis is frequently a multifactorial pathology, influenced by predisposing elements directly related to the patient, the surgical process, and drugs. A rare case of multifactorial postsurgical RML is presented in an elderly male patient, considered as risk factors, who required RRT and therefore, it increased hospitalization´s days.

Bibliographic Details

Carolina Forero-Carreño; Kateir Contreras Villamizar; Diana Carolina Vargas Ángel; Samuel Morales; Iván Salcedo; María Camila Echeverría

Asociacion Colombiana de Nefrologia e Hipertension Arterial

Medicine

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