Idiopathic membranous nephropathy combined with IgA nephropathy--two cases report and literature review

Objective To describe the clinical and pathological characteristics and diagnosis of membranous nephropathy combined with IgA nephropathy. Methods Two patients were confirmed to have idiopathic membranous nephropathy and IgA nephropathy in our hospital. We analyzed the clinical and pathological data and reviewed literature. Results Two patients were all male, 17 and 73 years old. One patient had nephrotic syndrome and microscopic hematuria, The other had proteinuria and microscopic hematuria initially, after 9 years performed nephrotic syndrome. Blood pressure and renal function of two patients were normal. The pathological characteristics included vacuolation and thickening of the glomerular basement membrane, mesangial cells and matrix hyperplasia. And IgA deposit in mesangium, IgG and C3 deposit in subepithelial site mainly. Lumpy electron dense deposited in subepithelial and mesangial area and foot processes fusion under electron microscopy. Two cases were remission after hormone therapy. During 29-41 months of follow up, the renal function remained normal. Conclusion Idiopathic membranous nephropathy combined with IgA nephropathy hadn't special clinical manifestation. Immunofluorescence, electron microscopy and immuno-electron microscopy in the diagnosis is important.