MEMBRANOUS NEPHROPATHY COMPLICATED WITH ACQUIRED HEMOPHILIA. PRESENTATION OF A RARE MEDICAL CONDITION

Iftikhar Ali, Wang Yingying, Shangqin Liu* and Shahzad Khan

ABSTRACT

A 63-year-old female patient presented with a large ecchymosis on her limbs, torso and buttocks. Few days prior to this event she suffered from facial cellulitis accompanied by suborbital and lower limb edema. That time she was diagnosed with membranous nephropathy and was discharged on angiotensin receptor blocker (Losartan). This time her coagulation factor VIII activity was decreased, and she was having heavy proteinuria. Her renal biopsy showed diffuse glomerular basement deposits of immunoglobulin G (IgG). A diagnosis of acquired hemophilia and concurrent membranous nephropathy was made. She was transfused with fresh frozen plasma and fibrinogen and immunosuppressives and was given rituximab. After one week of treatment the ecchymosis disappeared.

Keywords: Membranous nephropathy, acquired hemophilia, ecchymosis, hematoma.