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Membranous Lupus Nephropathy Initially Seen as Idiopathic Membranous NephropathyPossible Diagnostic Value of Tubular Reticular Structures
Martin A. Shearn, MD;
James Hopper, Jr, MD;
Claude G. Biava, MD
Arch Intern Med. 1980;140(11):1521-1523.
Abstract
• When a renal lesion is the sole manifestation of systemic lupus erythematosus (SLE), differentiation from other nephropathies is difficult. The membranous form of lupus nephritis is especially difficult to distinguish from idiopathic membranous nephropathy, particularly when multisystem and serologic features of SLE are absent. We report two cases in which the initial renal biopsy findings suggested idiopathic membranous nephropathy and in which the subsequent emergence of SLE might have been predicted by the presence of tubular reticular structures. We identified these structures in 177 of 183 (96.7%) renal biopsy specimens from patients with SLE, but in only three of 128 (2.3%) renal specimens from patients with membranous nephropathy. Tubular reticular structures are markers of the renal lesion of SLE and may be helpful in differentiation from membranous nephropathy.
(Arch Intern Med 140:1521-1523, 1980)
Author Affiliations
From the Department of Medicine, Kaiser-Permanente Medical Center, Oakland, Calif (Dr Shearn), and the Departments of Medicine (Dr Hopper) and Pathology (Dr Biava), University of California Medical Center, San Francisco.
Footnotes
Accepted for publication Jan 31, 1980.
Reprint requests to Department of Medical Education, Kaiser-Permanente Medical Center, 280 W MacArthur Blvd, Oakland, CA 94611 (Dr Shearn).
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