Membranous lupus nephritis with antineutrophil cytoplasmic antibody-associated segmental necrotizing and crescentic glomerulonephritis

Am J Kidney Dis. 1997 Jan;29(1):119-24. doi: 10.1016/s0272-6386(97)90018-4.


Focal segmental necrotizing and crescentic lupus nephritis accompanied by perinuclear antineutrophil cytoplasmic antibody (P-ANCA) seropositivity is an unusual occurrence. We report the first biopsy-documented cases of membranous lupus nephritis class V with associated "pauci-immune" segmental necrotizing glomerulonephritis and P-ANCA seropositivity. The absence of subendothelial electron-dense deposits favored a manifestation of superimposed ANCA-associated glomerulonephritis rather than class III lupus nephritis. The pathogenetic implications of this association are explored.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Antibodies, Antineutrophil Cytoplasmic / blood*
  • Biopsy
  • Diagnosis, Differential
  • Female
  • Fluorescent Antibody Technique, Indirect
  • Glomerulosclerosis, Focal Segmental / diagnosis*
  • Humans
  • Kidney / pathology
  • Lupus Nephritis / diagnosis*
  • Male
  • Microscopy, Electron
  • Middle Aged


  • Antibodies, Antineutrophil Cytoplasmic