Introduction:
Antiphospholipid antibody syndrome (APS) is a systemic autoimmune disorder characterized by thrombotic events and/or pregnancy morbidity and persistently elevated titers of antiphospholipid antibodies. Primary APS occurs without any associated condition and may subsequently develop features of definite systemic lupus erythematosus (SLE) or another associated autoimmune disease, at which time it is redefined as secondary APS. Nephrotic-range proteinuria is a rare manifestation of primary antiphospholipid syndrome (PAPS).
Methods:
A 25 year old female with a prior history of 2 unexplained abortions during the second trimester had come with complaints of bilateral lower limb swelling and high blood pressure recordings. Patient was evaluated during the second pregnancy and was found to have high titres of IgG Anti-beta-2 Glycoprotein 1 antibodies and IgG Anticardiolipin antibodies. However ANA was negative and was diagnosed with Primary APLA syndrome and was started on Anticoagulants and Angiotensin receptor blockers. However, the patient had progressively worsening pedal edema for 4 months. Upon evaluation found to have Nephrotic range proteinuria (Urine protein creatinine ratio -7, 24 hour urine protein - 5.6g), normal complement levels, low serum albumin and ANA-IF negative. Patient is planned for renal biopsy and tissue PLA2R. Serum PLA2R was not done.
Results:
Conclusions:
Primary MN is defined as the occurrence of an MN without any underlying disease or related condition. The association of MN with lupus-associated APS is common, although information on the prevalence of MN during primary APLA is limited. In the present case, SLE was ruled out based on absence of any clinical and immunological criteria for diagnosis. Rare cases of membranous nephropathy (MN) with APS and without any clinical or immunological characteristics of SLE have previously been reported in the literature
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.