Podocytic Infolding Glomerulopathy in a Patient with Phospholipase A2 Receptor-Positive Membranous Nephropathy and Review of the Literature

Nephron. 2021;145(5):496-502. doi: 10.1159/000515769. Epub 2021 May 7.

Abstract

Podocytic infolding glomerulopathy (PIG) is a rare diagnosis based on characteristic histopathologic findings on renal biopsy and was proposed as a new entity about a decade ago. It is a type of podocytic injury, characterized by invagination of the podocyte cell membrane (cytoplasmic projections from podocytes) into the glomerular basement membrane. The presence of microspheres and/or microtubules on electron microscopy is the characteristic finding. PIG is most often associated with autoimmune conditions like systemic lupus erythematosus. We report pathologic findings typical of PIG in a patient with phospholipase A2 receptor antibody-positive membranous nephropathy. She was treated with rituximab and responded well with decrease in proteinuria to the sub-nephrotic range.

Keywords: Antiphospholipid A2 receptor antibodies; Membranous nephropathy; Podocytic infolding; Rituximab.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Female
  • Glomerulonephritis, Membranous / diagnosis*
  • Glomerulonephritis, Membranous / drug therapy
  • Glomerulonephritis, Membranous / enzymology
  • Glomerulonephritis, Membranous / pathology
  • Humans
  • Kidney Glomerulus / pathology
  • Kidney Glomerulus / ultrastructure
  • Microscopy, Electron
  • Middle Aged
  • Podocytes / pathology*
  • Receptors, Phospholipase A2 / metabolism*
  • Rituximab / therapeutic use

Substances

  • Receptors, Phospholipase A2
  • Rituximab