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False Positive Hepatitis A IgM in Membranous Nephropathy: A Treatment Dilemma

Cilt: 47 Sayı: 2 21 Haziran 2025
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False Positive Hepatitis A IgM in Membranous Nephropathy: A Treatment Dilemma

Öz

Membranous nephropathy (MN) is a primary cause of nephrotic syndrome in adults, often linked to antibodies against M-type phospholipase A2 receptor (PLA2R). Immunosuppressive therapy, such as rituximab and calcineurin inhibitors, is utilized for high-risk patients. This case report discusses a 74-year-old female with anti-PLA2R-positive MN, whose treatment was delayed due to a false-positive hepatitis A virus (HAV)-IgM result. Despite asymptomatic presentation and normal liver function, concerns about potential viral reactivation complicated clinical decisions. After a month of monitoring, immunosuppressive treatment was initiated, and the patient’s proteinuria achieved remission. This case underscores the importance of thorough evaluation of serological results, especially in cases where viral markers could influence critical treatment decisions. The risk of delaying MN treatment must be balanced against the potential dangers of initiating therapy under uncertain viral infection status.

Anahtar Kelimeler

Destekleyen Kurum

Funding: The authors received no specific funding for this work. Conflict of interest: The authors declare that they have no conflict of interest. Availability of data and material: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Etik Beyan

Ethical approval: In this case report, ethical committee approval was not required; therefore, it was not obtained.

Kaynakça

  1. 1. Couser, W. G. Primary membranous nephropathy. Clin. J. Am. Soc. Nephrol. 12, 983– 997 (2017).
  2. 2. Debiec, H. et al. Antenatal membranous glomerulonephritis due to anti-neutral endopeptidase antibodies. N. Engl. J. Med. 346, 2053–2060 (2002)
  3. 3. Beck, L. H. et al. M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N. Engl. J. Med. 361, 11–21 (2009).
  4. 4. Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group. KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases. Kidney Int. 100, S1–S276 (2021)
  5. 5. van de Logt, A. E. et al. Immunological remission in PLA2R-antibody-associated membranous nephropathy: cyclophosphamide versus rituximab. Kidney Int. 93, 1016– 1017 (2018).
  6. 6. Lemon SM , Ott JJ , Van Damme P , Shouval D . Type A viral hepatitis: a summary and update on the molecular virology, epidemiology, pathogenesis and prevention. J Hepatol. 2017 Sep 5;68:167–84.
  7. 7. Bower WA , Nainan OV , Han X , Margolis HS . Duration of viremia in hepatitis A virus infection. J Infect Dis. 2000 Jul;182(1):12–7.
  8. 8. Cohen JI , Feinstone S , Purcell RH . Hepatitis A virus infection in a chimpanzee: duration of viremia and detection of virus in saliva and throat swabs. J Infect Dis. 1989 Nov;160(5):887–90.

Ayrıntılar

Birincil Dil

İngilizce

Konular

Sağlık Hizmetleri ve Sistemleri (Diğer)

Bölüm

Olgu Sunumu

Yazarlar

Yayımlanma Tarihi

21 Haziran 2025

Gönderilme Tarihi

21 Mart 2025

Kabul Tarihi

16 Mayıs 2025

Yayımlandığı Sayı

Yıl 2025 Cilt: 47 Sayı: 2

DOI

https://doi.org/10.7197/cmj.1662807

IZ

https://izlik.org/JA37SK87SJ

Kaynak Göster

RIS / Bibtex
APA
Cetin, T. E., Karataş, A., Telli Dizman, G., Akçay, Ö. F., & Helvacı, Ö. (2025). False Positive Hepatitis A IgM in Membranous Nephropathy: A Treatment Dilemma. Cumhuriyet Medical Journal, 47(2), 45-47. https://doi.org/10.7197/cmj.1662807
AMA
1.Cetin TE, Karataş A, Telli Dizman G, Akçay ÖF, Helvacı Ö. False Positive Hepatitis A IgM in Membranous Nephropathy: A Treatment Dilemma. CMJ. 2025;47(2):45-47. doi:10.7197/cmj.1662807
Chicago
Cetin, Taha Enes, Ali Karataş, Gülçin Telli Dizman, Ömer Faruk Akçay, ve Özant Helvacı. 2025. “False Positive Hepatitis A IgM in Membranous Nephropathy: A Treatment Dilemma”. Cumhuriyet Medical Journal 47 (2): 45-47. https://doi.org/10.7197/cmj.1662807.
EndNote
Cetin TE, Karataş A, Telli Dizman G, Akçay ÖF, Helvacı Ö (01 Haziran 2025) False Positive Hepatitis A IgM in Membranous Nephropathy: A Treatment Dilemma. Cumhuriyet Medical Journal 47 2 45–47.
IEEE
[1]T. E. Cetin, A. Karataş, G. Telli Dizman, Ö. F. Akçay, ve Ö. Helvacı, “False Positive Hepatitis A IgM in Membranous Nephropathy: A Treatment Dilemma”, CMJ, c. 47, sy 2, ss. 45–47, Haz. 2025, doi: 10.7197/cmj.1662807.
ISNAD
Cetin, Taha Enes - Karataş, Ali - Telli Dizman, Gülçin - Akçay, Ömer Faruk - Helvacı, Özant. “False Positive Hepatitis A IgM in Membranous Nephropathy: A Treatment Dilemma”. Cumhuriyet Medical Journal 47/2 (01 Haziran 2025): 45-47. https://doi.org/10.7197/cmj.1662807.
JAMA
1.Cetin TE, Karataş A, Telli Dizman G, Akçay ÖF, Helvacı Ö. False Positive Hepatitis A IgM in Membranous Nephropathy: A Treatment Dilemma. CMJ. 2025;47:45–47.
MLA
Cetin, Taha Enes, vd. “False Positive Hepatitis A IgM in Membranous Nephropathy: A Treatment Dilemma”. Cumhuriyet Medical Journal, c. 47, sy 2, Haziran 2025, ss. 45-47, doi:10.7197/cmj.1662807.
Vancouver
1.Taha Enes Cetin, Ali Karataş, Gülçin Telli Dizman, Ömer Faruk Akçay, Özant Helvacı. False Positive Hepatitis A IgM in Membranous Nephropathy: A Treatment Dilemma. CMJ. 01 Haziran 2025;47(2):45-7. doi:10.7197/cmj.1662807