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Membranous Nephropathy in Relapsing Polychondritis A Rare Case and Its Clinical Implications

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by

Vishnu
in

Introduction

Relapsing polychondritis (RP) is a rare systemic inflammatory disorder characterized by recurrent inflammation and destruction of cartilaginous structures. While it commonly affects the ears, nose, joints, and respiratory tract, renal involvement is exceptionally rare. This case report presents an unusual occurrence of membranous nephropathy (MN) as a complication of RP.

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Case Summary

A 67-year-old male with a history of chronic renal disease and longstanding proteinuria presented with progressive dyspnea, auricular inflammation, and cartilage collapse. Imaging confirmed active inflammation in cartilaginous structures, leading to a diagnosis of RP.

Key Findings:

  • Renal biopsy revealed membranous nephropathy with granular immune complex deposits.
  • Treatment with etanercept, a tumor necrosis factor (TNF) alpha inhibitor, improved both renal and respiratory symptoms.
  • Despite initial improvement, complications of RP and treatment-related infections led to progressive decline and eventual mortality.

Broader Implications in Nephrology

Membranous nephropathy is often associated with autoimmune conditions, but its link with RP remains largely unexplored. The American Society of Nephrology (ASN) highlights the importance of early renal biopsy in patients with autoimmune diseases to prevent complications.

Strategic Link Placement

Conclusion and Call-to-Action

This case underscores the need for vigilance in detecting renal involvement in RP patients. TNF-alpha inhibitors like etanercept may hold promise in managing renal complications but require further research.

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