B형 간염 항원 양성환자에서 발생한 막성 신염과 IgA 신증의 중복 신염 1예

Abstract

Membranous nephropathy and IgA nephropathy are relatively common lesions among primary glomerular diseases. However, a case of glomerulonephritis combining the features of IgA nephropathy and membranous nephropathy has rarely been reported. We are reporting such a case with features of both IgA and membranous nephropathy associated with hepatitis B surface antigenemia. A 43-year-old man with hepatitis B surface antigenemia developed the nephrotic syndrome. Renal biopsy revealed a glomerulonephritis with features of both IgA nephropathy and membranous nephropathy. Light microscopy showed mild, focal mesangial expansion and hypercellularity. Immunofluorescence microsocopy demonstrated both granular deposits of IgA in the mesangium and granular deposits of IgG along the capillary loops. On electron microscopy, electron dense deposits were identified not only in the para-mesangial area but also on the subepithelial side of glomerular basement membrane.