Letter to the Editor
Fibrillary glomerulonephritis simulating glomerular basal antimembrane antibody disease with associated thrombotic microangiopathy and ANCAp
Glomerulonefritis con depósitos fibrilares simulando enfermedad por anticuerpos antimembrana basal glomerular con microangiopatía trombótica asociada y ANCAp
M. Dolores Sánchez de la Nieta Garcíaa,
, Lucía González Lópezb, Paz Castro Fernándezc, Minerva Arambarri Seguraa, Alberto Martínez-Caleroa, Marina Alonso Riañod, Ana Sánchez-Fructuosoa
Corresponding author
a Servicio de Nefrología, Hospital Universitario Clínico San Carlos, Madrid, Spain
b Servicio de Anatomía Patológica, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
c Servicio de Nefrología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
d Servicio de Anatomía Patológica, Hospital Universitario 12 de Octubre, Madrid, Spain
Read
1756
Timeswas read the article
758
Total PDF
998
Total HTML
Share statistics
array:24 [ "pii" => "S2013251423000913" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2023.05.015" "estado" => "S300" "fechaPublicacion" => "2023-03-01" "aid" => "907" "copyright" => "Sociedad Española de Nefrología" "copyrightAnyo" => "2021" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Nefrologia (English Version). 2023;43:255-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S0211699521001326" "issn" => "02116995" "doi" => "10.1016/j.nefro.2021.03.009" "estado" => "S300" "fechaPublicacion" => "2023-03-01" "aid" => "907" "copyright" => "Sociedad Española de Nefrología" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia. 2023;43:255-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Glomerulonefritis con depósitos fibrilares simulando enfermedad por anticuerpos antimembrana basal glomerular con microangiopatía trombótica asociada y ANCAp" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "255" "paginaFinal" => "257" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Fibrillary glomerulonephritis simulating glomerular basal antimembrane antibody disease with associated thrombotic microangiopathy and ANCAp" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 709 "Ancho" => 1255 "Tamanyo" => 207871 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Superior izquierda: glomérulo con semiluna epitelial circunferencial con disrupción de la membrana basal y tinción positiva de las basales y del mesangio. Plata de Jones ×40. Superior derecha: positividad granular mesangial y seudolineal 2+<span class="elsevierStyleHsp" style=""></span>de C3. IFD C3<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>40. Inferior izquierda: positividad lineal/seudolineal 3+<span class="elsevierStyleHsp" style=""></span>parietal de IgG. IFD IgG<span class="elsevierStyleHsp" style=""></span>×40. Inferior derecha: mediante ME, se observan depósitos densos, en banda y continuos, de aspecto lineal, a lo largo de la lámina densa de las membranas basales glomerulares y en el mesangio constituidos por fibrillas de disposición aleatoria, cuyo grosor medio fue de 18,41<span class="elsevierStyleHsp" style=""></span>nm.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Dolores Sánchez de la Nieta García, Lucía González López, Paz Castro Fernández, Minerva Arambarri Segura, Alberto Martínez-Calero, Marina Alonso Riaño, Ana Sánchez-Fructuoso" "autores" => array:7 [ 0 => array:2 [ "nombre" => "M. Dolores" "apellidos" => "Sánchez de la Nieta García" ] 1 => array:2 [ "nombre" => "Lucía" "apellidos" => "González López" ] 2 => array:2 [ "nombre" => "Paz" "apellidos" => "Castro Fernández" ] 3 => array:2 [ "nombre" => "Minerva" "apellidos" => "Arambarri Segura" ] 4 => array:2 [ "nombre" => "Alberto" "apellidos" => "Martínez-Calero" ] 5 => array:2 [ "nombre" => "Marina" "apellidos" => "Alonso Riaño" ] 6 => array:2 [ "nombre" => "Ana" "apellidos" => "Sánchez-Fructuoso" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2013251423000913" "doi" => "10.1016/j.nefroe.2023.05.015" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251423000913?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699521001326?idApp=UINPBA000064" "url" => "/02116995/0000004300000002/v1_202303240922/S0211699521001326/v1_202303240922/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2013251423000937" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2023.06.001" "estado" => "S300" "fechaPublicacion" => "2023-03-01" "aid" => "914" "copyright" => "Sociedad Española de Nefrología" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Nefrologia (English Version). 2023;43:257-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Bilateral hip osteonecrosis and cholelithiasis after eculizumab discontinuation in atypical haemolytic uraemic syndrome" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "257" "paginaFinal" => "259" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Osteonecrosis bilateral de cadera y colelitiasis tras la interrupción de eculizumab en sindrome hemolitico uremico atípico" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 494 "Ancho" => 1005 "Tamanyo" => 46507 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">X-ray of both femoral heads at diagnosis.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Mercedes Ubetagoyena Arrieta, Laura Montes Medina, Leyre Perez Sukia" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Mercedes" "apellidos" => "Ubetagoyena Arrieta" ] 1 => array:2 [ "nombre" => "Laura" "apellidos" => "Montes Medina" ] 2 => array:2 [ "nombre" => "Leyre" "apellidos" => "Perez Sukia" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0211699521001399" "doi" => "10.1016/j.nefro.2021.03.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699521001399?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251423000937?idApp=UINPBA000064" "url" => "/20132514/0000004300000002/v1_202307191022/S2013251423000937/v1_202307191022/en/main.assets" ] "itemAnterior" => array:17 [ "pii" => "S2013251422001110" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2021.06.006" "estado" => "S300" "fechaPublicacion" => "2023-03-01" "aid" => "909" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Nefrologia (English Version). 2023;43:254-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Beyond the zero-liquid discharge: Consider a “fit for purpose” water philosophy in hemodialysis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "254" "paginaFinal" => "255" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Más allá de la descarga de líquido cero: considere una filosofía de agua “adecuada para su propósito” en hemodiálisis" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Mohammed Asserraji, Merouane Belarbi, Ahmed Amine Jawhar, Omar Maoujoud, Nadir Zemraoui" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Mohammed" "apellidos" => "Asserraji" ] 1 => array:2 [ "nombre" => "Merouane" "apellidos" => "Belarbi" ] 2 => array:2 [ "nombre" => "Ahmed Amine" "apellidos" => "Jawhar" ] 3 => array:2 [ "nombre" => "Omar" "apellidos" => "Maoujoud" ] 4 => array:2 [ "nombre" => "Nadir" "apellidos" => "Zemraoui" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251422001110?idApp=UINPBA000064" "url" => "/20132514/0000004300000002/v1_202307191022/S2013251422001110/v1_202307191022/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Fibrillary glomerulonephritis simulating glomerular basal antimembrane antibody disease with associated thrombotic microangiopathy and ANCAp" "tieneTextoCompleto" => true "saludo" => "Mr. Director:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "255" "paginaFinal" => "257" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. Dolores Sánchez de la Nieta García, Lucía González López, Paz Castro Fernández, Minerva Arambarri Segura, Alberto Martínez-Calero, Marina Alonso Riaño, Ana Sánchez-Fructuoso" "autores" => array:7 [ 0 => array:4 [ "nombre" => "M. Dolores" "apellidos" => "Sánchez de la Nieta García" "email" => array:1 [ 0 => "sanchezdelanieta@senefro.org" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Lucía" "apellidos" => "González López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Paz" "apellidos" => "Castro Fernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Minerva" "apellidos" => "Arambarri Segura" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Alberto" "apellidos" => "Martínez-Calero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Marina" "apellidos" => "Alonso Riaño" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 6 => array:3 [ "nombre" => "Ana" "apellidos" => "Sánchez-Fructuoso" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Nefrología, Hospital Universitario Clínico San Carlos, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Nefrología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Universitario 12 de Octubre, Madrid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Glomerulonefritis con depósitos fibrilares simulando enfermedad por anticuerpos antimembrana basal glomerular con microangiopatía trombótica asociada y ANCAp" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 709 "Ancho" => 1255 "Tamanyo" => 208083 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Upper left: glomerulus with circumferential epithelial crescent with disruption of the basement membrane and positive staining of the basals and mesangium. Jones silver ×40. Upper right: mesangial granular and pseudolinear 2+ de C3 positivity. IFD C3 × 40. Lower left: linear/pseudolinear 3+ parietal IgG positivity. IFD IgG × 40. Lower right: by EM, dense, banded and continuous deposits, linear in appearance, are observed along the lamina densa of the glomerular basement membranes and in the mesangium constituted by randomly arranged fibrils, whose mean thickness was 18.41 nm.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Fibrillary glomerulonephritis (FGN) is a glomerular disease with organized deposits of immunoglobulins, negative Congo red staining and 16−24 nm fibrils visible in electron microscopy (EM). The clinical syndrome in these patients is variable: nephritic or nephrotic syndrome, microhematuria, hypertension, renal failure and, rarely, rapidly progressive glomerulonephritis (RPG), pulmonary hemorrhage or thrombotic microangiopathy (TMA).<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–6</span></a> We describe a FGN, with RPG, pulmonary hemorrhage, and positive ANCAp and TMA.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Female, 51 years old, with no relevant medical history, consults for dyspnea and edema. On examination, blood pressure 170/100 mmHg, sinus rhythm, crackles in both lung bases and edema. Hemogram and blood chemistry: normocytic normochromic anemia, without microangiopathic hemolytic anemia (MHA), creatinine 6 mg/dl, nephrotic proteinuria with normal serum albumin and microhematuria. Chest X-ray: bilateral interstitial infiltrate, with diagnosis of pulmonary hemorrhage with immunological study with ANCAp positive 1/320, rest normal/negative, including anti-glomerular basement membrane antibodies. Plasmapheresis, corticosteroids and intravenous cyclophosphamide were started. One week after admission, MHA with smear showing schistocytes and undetectable haptoglobin, with negative stool culture, normal ADAMTS13, we decided to start eculizumab treatment, with normal genetic follow-up Renal biopsy: 49 glomeruli, 10 sclerosed, 29 with epithelial crescents, some with segmental necrosis, PAS and Jones silver positive. No signs of TMA. Direct immunofluorescence was strongly positive for IgG with linear pattern, kappa and lambda positive, weak C3 with parietal and mesangial granular pattern, IgG4 positive (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">At hospital discharge, the patient presented remission of pulmonary hemorrhage and resolution of MHA, creatinine of 3.8 mg/dl, proteinuria and microhematuria, and continued treatment with cyclophosphamide, corticosteroids and eculizumab up to 2 months after resolution of MHA. Thirty days after discontinuation of eculizumab, she presented a new episode of probable TMA and the ME result was received: dense deposits, in glomerular basement membrane (GBM) and mesangium, consisting of random fibrils, with an average thickness of 18.41 nm, compatible with fibrillary glomerulopathy, with linear IgG deposits (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). DNAJB9 testing by immunohistochemistry was positive, and we restarted eculizumab, with suspicion of secondary TMA. After 6 months of cyclophosphamide, we maintained treatment with azathioprine. For 2.5 months, she presented clinical and renal function stability, with no MHA data; treatment with eculizumab was maintained for 3 months and subsequently renal function improved with no MHA data. Three months after discontinuation, the patient presented deterioration of renal function, and eculizumab was reinitiated until her inclusion in chronic treatment with peritoneal dialysis, 9 months later (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Fibrillary glomerulonephritis rarely presents as it did in this case, with acute renal failure and pulmonary hemorrhage. Different authors suggest the possibility of a circulating factor in GF, which may be responsible for the existence of fibrillar material at pulmonary level, triggering pulmonary hemorrhage.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> For the diagnosis of FGN, EM is necessary, or DNAJB9 by immunohistochemistry if EM is not available. In our case, despite diagnosis made by EM, we tested for DNAJB9 with a positive result.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7–9</span></a> The linear/pseudolinear IgG deposits described in FGN and in our patient resembles a GBM antibody disease, which makes us rule out FGN when present or suggest coexistence.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> The presence of RPG and TMA is rare, but may occur in FGN, even in association with GBMD.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2,4,7</span></a> In fact, Bircan et al. explain that the concurrence of these entities may be due to endothelial injury produced by vasculitis in patients with susceptibility due to FGN with factor H deficiency, triggering TMA in patient with vasculitis and FGN. In our patient we ruled out susceptibility due to absence of factor H deficiency, but the 3 conditions coexisted: FGN, vasculitis, and TMA.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> FGN probably associated with GBMD with ANCAp+ and TMA has not been previously described in the literature, to our knowledge.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 709 "Ancho" => 1255 "Tamanyo" => 208083 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Upper left: glomerulus with circumferential epithelial crescent with disruption of the basement membrane and positive staining of the basals and mesangium. Jones silver ×40. Upper right: mesangial granular and pseudolinear 2+ de C3 positivity. IFD C3 × 40. Lower left: linear/pseudolinear 3+ parietal IgG positivity. IFD IgG × 40. Lower right: by EM, dense, banded and continuous deposits, linear in appearance, are observed along the lamina densa of the glomerular basement membranes and in the mesangium constituted by randomly arranged fibrils, whose mean thickness was 18.41 nm.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1584 "Ancho" => 2917 "Tamanyo" => 275174 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fibrillary glomerulonephritis: a report of 66 cases from a single institution" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.H. Nasr" 1 => "A.M.F.C. Valeri" 2 => "F.C. Fervenza" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2215/CJN.08300910" "Revista" => array:6 [ "tituloSerie" => "Clin J Am Soc Nephrol." "fecha" => "2011" "volumen" => "6" "paginaInicial" => "775" "paginaFinal" => "784" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21441134" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fibrillary glomerulonephritis masquerading as rapidly progressive glomerulonephritis with pseudo-linear glomerular basement membrane staining" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Husseini" 1 => "J.C. Aycinena" 2 => "B. George" 3 => "S. Jennings" 4 => "V. Cornea" 5 => "B.P. Sawaya" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5414/CN108508" "Revista" => array:6 [ "tituloSerie" => "Clin Nephrol." "fecha" => "2015" "volumen" => "84" "paginaInicial" => "231" "paginaFinal" => "235" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26249548" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapidly progressive glomerulonephritis due to coexistent anti-glomerular basement membrane disease and fibrillary glomerulonephritis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W. Cheungpasitporn" 1 => "C.C. Zacharek" 2 => "F.C. Fervenza" 3 => "L.D. Cornell" 4 => "S. Sanjeev Sethi" 5 => "L.P. Herrera Hernández" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Kid J." "fecha" => "2016" "volumen" => "9" "paginaInicial" => "97" "paginaFinal" => "101" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case of fibrillary glomerulonephritis associated with thrombotic microangiopathy and anti-glomerular basement membrane antibody" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Momose" 1 => "T. Nakajima" 2 => "S. Chiba" 3 => "K. Kumakawa" 4 => "Y. Shiraiwa" 5 => "N. Sasaki" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000371802" "Revista" => array:6 [ "tituloSerie" => "Nephron Extra." "fecha" => "2015" "volumen" => "5" "paginaInicial" => "30" "paginaFinal" => "38" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25873933" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary hemorrhage in a patient with fibrillary glomerulonephritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.G. Masson" 1 => "H.G. Rennke" 2 => "M.N. Gottlieb" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM199201023260106" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med." "fecha" => "1992" "volumen" => "326" "paginaInicial" => "36" "paginaFinal" => "39" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1727064" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fibrillary glomerulonephritis with crescentic and necrotizing glomerulonephritis and concurrent thrombotic microangiopathy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Tsui" 1 => "P. Dokouhaki" 2 => "B. Prasad" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000492529" "Revista" => array:7 [ "tituloSerie" => "Case Rep Nephrol Dial." "fecha" => "2018" "volumen" => "8" "paginaInicial" => "182" "paginaFinal" => "191" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30320122" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S030228381501177X" "estado" => "S300" "issn" => "03022838" ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "New developments in the diagnosis of fibrillary glomerulonephritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.H. Nasr" 1 => "A.B. Fogo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.kint.2019.03.021" "Revista" => array:6 [ "tituloSerie" => "Kidney Int." "fecha" => "2019" "volumen" => "96" "paginaInicial" => "581" "paginaFinal" => "592" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31227146" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Serum levels of DNAJB9 are elevated in fibrillary glomerulonephritis patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.H. Nasr" 1 => "S. Dasari" 2 => "J.C. Lieske" 3 => "L.M. Benson" 4 => "P.M. Vanderboom" 5 => "C.J. Holtz-Heppelmann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.kint.2019.01.024" "Revista" => array:6 [ "tituloSerie" => "Kidney Int." "fecha" => "2019" "volumen" => "95" "paginaInicial" => "1269" "paginaFinal" => "1272" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31010480" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "DNAJB9 is a specific immunohistochemical marker for fibrillary glomerulonephritis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.H. Nasr" 1 => "J.A. Vrana" 2 => "S. Dasari" 3 => "F. Bridoux" 4 => "M.E. Fidler" 5 => "S. Kaaki" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Kidney Int Rep." "fecha" => "2017" "volumen" => "3" "paginaInicial" => "56" "paginaFinal" => "64" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Factor H deficiency and fibrillary glomerulopathy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Z. Bircan" 1 => "D. Toprak" 2 => "I. Kilicaslan" 3 => "S. Solakoglu" 4 => "V. Uysal" 5 => "D. Ponard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ndt/gfg605" "Revista" => array:6 [ "tituloSerie" => "Nephrol Dial Transplant." "fecha" => "2004" "volumen" => "19" "paginaInicial" => "727" "paginaFinal" => "730" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14767033" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000004300000002/v1_202307191022/S2013251423000913/v1_202307191022/en/main.assets" "Apartado" => array:4 [ "identificador" => "35436" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000004300000002/v1_202307191022/S2013251423000913/v1_202307191022/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251423000913?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 75 | 46 | 121 |
| 2024 September | 77 | 37 | 114 |
| 2024 August | 96 | 72 | 168 |
| 2024 July | 40 | 37 | 77 |
| 2024 June | 65 | 49 | 114 |
| 2024 May | 70 | 47 | 117 |
| 2024 April | 54 | 37 | 91 |
| 2024 March | 41 | 26 | 67 |
| 2024 February | 39 | 41 | 80 |
| 2024 January | 29 | 31 | 60 |
| 2023 December | 25 | 27 | 52 |
| 2023 November | 51 | 47 | 98 |
| 2023 October | 41 | 49 | 90 |
| 2023 September | 44 | 39 | 83 |
| 2023 August | 112 | 38 | 150 |
| 2023 July | 98 | 86 | 184 |
| 2023 June | 41 | 49 | 90 |
Show all
