Membranous nephropathy associated with Alport syndrome

A 38-year-old man presented with nephrotic syndrome and hypertension for five years.He had normal visual acuity and hearing,and denied hereditary nephropathy in his family.Renal biopsy showed non-typical membranous nephropathy by the light microscope and immunofluorescence.In addition,there were several unusual clusters of foam cells in the renal interstitial area.Type IV collagen staining showed that the expression of the alpha3 was faint in the GBM(glomerular basement membrane) and normal in TBM(tubular basement membrane).Electron microscope indicated the splitting of the lamina densa of GBM,and subepithelial electron dense deposits.The final diagnosis was Alport syndrome associated with membranous nephropathy.