Idiopathic membranous nephropathy in children: A case report

Table 1 Results of laboratory tests performed at our hospital

	Index	Result	Reference range
Blood count	White blood cell count (109/L)	7.23	3.6-9.7
	Hemoglobin (g/L)	120	110-146
	Platelet count (109/L)	379	100-450
Urinary chemistry	Urinary protein (g/24 h)	2.51	0-0.15
	Urinary protein	4+	Negative
	Urinary red blood cell count (cells/HP)	4+	0-3
	Urinary leukocyte count (cells/HP)	4+	0-5
	Pathological casts	Positive	Negative
Serum chemistry	Albumin (g/L)	20	35-50
	Total cholesterol (mmol/L)	6.29	< 5.18
	Triglyceride (mmol/L)	1.38	< 1.7
	Blood urea nitrogen (mmol/L)	4.76	3.2-7.1
	Serum creatinine (μmol/L)	35	17.3-54.6
Immunology	Immunoglobulin G (g/L)	2.21	5.29-21.9
	Immunoglobulin A (g/L)	0.39	0.41-3.95
	Immunoglobulin M (g/L)	0.96	0.48-2.26
	Immunoglobulin E (g/L)	17.2	< 90
	Complement C3 (g/L)	0.98	0.7-2.06
	Complement C4 (g/L)	0.18	0.11-0.61
	Complement C1q (mg/dL)	23.9	15.7-23.7

Note: Bold font indicates abnormal values.

Table 2 Results of urinalysis during follow-up

Time of follow-up (d)	Urinary proteinuria	Urinary RBC count (cells/μL)	Urinary WBC count (cells/μL)	Urinary pathologic casts (cells/μL)
0	4+	1066	98	14
16	2+	280	9	0
60	3+	325	34	0
77	3+	1689	91.9	4.81
118	3+	1286	14	0
130	Negative	53	3	0
144	Negative	59	10	0

RBC: Red blood cell: WBC: White blood cell.

Table 3 Differences between idiopathic membranous nephropathy and minimal change disease in children

		IMN	MCD
General features	Sex	Male	Male
	Age	Adolescence	Preschool age
Clinical manifestations	Nephrotic syndrome	Common	Common
	Leukocyturia	Some	Rare
	Hematuria	Some	Rare
	Hypertension	Some	Rare
	Renal failure	Some	Rare
Laboratory tests	Anti-PLA2R, antibody	Elevated	Normal
	Anti-THSD7A, antibody	Elevated	Normal
Treatment strategy	Prednisone	Mostly resistance	Mostly sensitive
	Immunosuppressant	Tacrolimus, cyclophosphamide, mycophenolate mofetil	Rare
	Biological agent	Rituximab	Rare

PLA₂R: Phospholipase A₂ receptor; THSD7A: Thrombospondin type-1 domain-containing 7A; IMN: Idiopathic membranous nephropathy; MCD: Minimal change disease.