English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

M. Serrano Comino, Sandalo, No. 5, Madrid 22 (Spain) Dear Sir, The association of rheumatoid arthritis (RA) and an-ylosing spondylitis (AS) is extremely rare. According to some authors [1, 2], taking into account the prevalence of each disease individually, the association rate of both entities could vary between 1:50,000 and 1:1,000,000 cases. Further, the presence of membranous nephropathy (MN) in patients with any of both rheumatic conditions is only exceptionally mentioned. Therefore we believe the present short report of a patient suffering from RA and AS who developed signs of renal function impairment due to histologically proven MN to be of interest. The patient was a 35-years-old man diagnosed having RA at the age of 23 by clinical and serological criteria [3, 4] with a positive latex reaction at a titer of 1:260. A total dose of 0.5 g gold salt was administered as an initial therapy followed in the ensuing years by variable dose schedules of steroid and/or nonsteroidal anti-inflammatory drugs. 12 years after the initial diagnosis, the patient was admitted to our department because of marked muscle stiffness and aching pain on the back. There was unequivocal x-ray evidence of advanced sacroileitis. The latex test was found to be positive at a titer of 1:2,560 but other tests including antinuclear antibodies were negative. CH50, C3 and C4 serum levels were well within the normal limits. The HLA phenotype was found to be A2/A3/Bw44, B27/Cwl, Cw5/4A, DR1. A skin biopsy failed to show inmunoglobulin deposits. Significant pro-teinuria (4 g/24 h) was present, serum creatinine being 1 mg/dl (88 μmol/l) and serum albumin 30 g/l, but no gross abnormalities were detected on fresh urine dark field examination. A renal biopsy was performed that revealed a histological pattern of MN by LM and EM (fig. 1) as well as by immunofluorescence. 3 years later Fig. 1. Electron mecrograph showing electron-dense subepithel-ial deposits. no significant deterioration in renal function was apparent. As alluded to earlier, the rare cases of nephropathy associated with AS are occasionally interpreted as a consequence of secondary amyloidosis and/or as an expression of analgesic nephropathy. However, some patients with mesangioproliferative and/or focal glomerulonephritis are known [4, 5], although only very recently, a patient with AS and MN has been reported. Despite the renal involvement in RA, most cases are either due to amyloidosis or to analgesic nephropathy. MN is known to be produced by penicillamine and gold therapy,

Membranous Nephropathy in a Patient with Ankylosing Spondylitis and Rheumatoid Arthritis