Syphilis as the great mimicker: A case of full‐house pattern membranous nephropathy

Author:

Fan Shu Ling1ORCID,Landgren Anthony2,Ruderman Irene1

Affiliation:

1. Department of Nephrology Royal Melbourne Hospital Melbourne Victoria Australia

2. Department of Anatomical Pathology Royal Melbourne Hospital Melbourne Victoria Australia

Abstract

AbstractSyphilis is a known cause of membranous nephropathy. We describe a case of a patient presenting with nephrotic syndrome whose renal biopsy demonstrated a ‘full house’ immunohistochemical pattern with positive IgG, IgM, C1q, IgA, C3c, and C4d staining. He was treated with immunosuppressive agents for minimal change nephropathy and subsequently class V lupus nephritis, before syphilis infection was confirmed. Following treatment with a single dose of intramuscular benzathine penicillin there was complete and rapid resolution of nephrotic syndrome. With progressive rising incidence in the western world, syphilis is an important and under‐recognised differential diagnosis in cases of nephrotic syndrome.

Publisher

Wiley

Subject

Nephrology,General Medicine

Reference6 articles.

1. Syphilis

2. Renal manifestations of syphilis

3. Centers for Disease Control and Prevention.Sexually Transmitted Disease Surveillance 2021: Syphilis; 2023. Accessed 30 April 2023.https://www.cdc.gov/std/statistics/2021/overview.htm#Syphilis

4. Immunopathogenesis of Syphilitic Glomerulonephritis

5. Membranous Glomerulonephritis as an Uncommon Presentation of Secondary Syphilis: A Reminder on Therapeutic Decision-Making in Clinical Practice

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