Anti-phospholipase A2 receptor-associated membranous nephropathy with human immunodeficiency virus infection treated with telitacicept:A case report  

作　　者：Jin-Ling Wang Yan-Ling Sun Zhe Kang Sheng-Kun Zhang Chun-Xin Yu Wan Zhang Hua Xie Hong-Li Lin 

机构地区：[1]Department of Nephrology,Dalian Renal Care Hospital,Dalian 116000,Liaoning Province,China [2]Department of Nephrology,The First Affiliated Hospital of Dalian Medical University,Dalian 116000,Liaoning Province,China

出　　处：《World Journal of Clinical Cases》2023年第22期5309-5315,共7页世界临床病例杂志

摘　　要：BACKGROUND The co-occurrence of Anti-phospholipase A2 receptor-associated membranous nephropathy(anti-PLA2R-MN)and human immunodeficiency virus(HIV)infection is a rare clinical scenario,presenting significant challenges in terms of management and treatment.CASE SUMMARY A 32-year-old Chinese male diagnosed with HIV infection presented with a clinical history of proteinuria persisting for over two years.A kidney biopsy demonstrated subepithelial immune complex deposition and a thickened glomerular basement membrane,indicative of stage I-II membranous nephro-pathy.Immunofluorescence staining revealed granular deposition of PLA2R(3+)along the glomerular capillary loops,corroborated by a strongly positive anti-PLA2R antibody test(1:320).Initial treatment involving losartan potassium,rivaroxaban,tacrolimus,and rituximab was discontinued due to either poor effec-tiveness or the occurrence of adverse events.Following a regimen of weekly subcutaneous injections of telitacicept(160 mg),a marked decline in the 24 h urine protein was observed within a three-month period,accompanied by a rise in serum albumin level.No significant reductions in peripheral blood CD3+CD4+T and CD3+CD8+T cell counts were detected.The patient's physical and psychological conditions showed significant improvements,with no adverse events reported during the treatment course.CONCLUSION Telitacicept might offer a potential therapeutic avenue for patients diagnosed with anti-PLA2R-MN concomitant with HIV infection.

关 键 词：Membranous nephropathy PLA2R Human immunodeficiency virus PROTEINURIA Telitacicept Case report 

分 类 号：R692[医药卫生—泌尿科学]