{"id":"https://openalex.org/W4416865696","doi":"https://doi.org/10.1681/asn.2025hmq3x872","title":"\"The Chicken or the Egg\": A Unique Case of Secondary Membranous Nephropathy","display_name":"\"The Chicken or the Egg\": A Unique Case of Secondary Membranous Nephropathy","publication_year":2025,"publication_date":"2025-10-01","ids":{"openalex":"https://openalex.org/W4416865696","doi":"https://doi.org/10.1681/asn.2025hmq3x872"},"language":"en","primary_location":{"id":"doi:10.1681/asn.2025hmq3x872","doi":"https://doi.org/10.1681/asn.2025hmq3x872","is_oa":false,"landing_page_url":"https://doi.org/10.1681/asn.2025hmq3x872","pdf_url":null,"source":{"id":"https://openalex.org/S115693375","display_name":"Journal of the American Society of Nephrology","issn_l":"1046-6673","issn":["1046-6673","1533-3450"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","doyens","jufo-3","ki-jl-3","medline","norway-2"],"host_organization":"https://openalex.org/P4310315620","host_organization_name":"American Society of Nephrology","host_organization_lineage":["https://openalex.org/P4310315620"],"host_organization_lineage_names":["American Society of Nephrology"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Society of Nephrology","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5098690268","display_name":"Elvira Gonz\u00e1lez Negrete","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Elvira Gonz\u00e1lez Negrete","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5019589228","display_name":"Golnaz Vahdani","orcid":"https://orcid.org/0000-0003-0698-2968","observed_orcids":["https://orcid.org/0000-0003-0698-2968"]},"institutions":[{"id":"https://openalex.org/I138006243","display_name":"University of Arizona","ror":"https://ror.org/03m2x1q45","country_code":"US","type":"education","lineage":["https://openalex.org/I138006243"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Golnaz Vahdani","raw_affiliation_strings":["The University of Arizona, Tucson, Arizona, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The University of Arizona, Tucson, Arizona, United States","institution_ids":["https://openalex.org/I138006243"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.62,"has_fulltext":false,"cited_by_count":1,"citation_normalized_percentile":{"value":0.74279813,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":93,"max":96},"biblio":{"volume":"36","issue":"10S","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11029","display_name":"Renal Diseases and Glomerulopathies","score":0.5952000021934509,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11029","display_name":"Renal Diseases and Glomerulopathies","score":0.5952000021934509,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11730","display_name":"Autoimmune Bullous Skin Diseases","score":0.23489999771118164,"subfield":{"id":"https://openalex.org/subfields/2734","display_name":"Pathology and Forensic Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10697","display_name":"Vasculitis and related conditions","score":0.06930000334978104,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/follicular-dendritic-cell-sarcoma","display_name":"follicular dendritic cell sarcoma","score":0.9819999933242798},{"id":"https://openalex.org/keywords/pemphigus-vulgaris","display_name":"pemphigus vulgaris","score":0.8640000224113464},{"id":"https://openalex.org/keywords/myasthenia-gravis","display_name":"myasthenia gravis","score":0.9800000190734863},{"id":"https://openalex.org/keywords/secondary-membranous-nephropathy","display_name":"secondary membranous nephropathy","score":0.9620000123977661},{"id":"https://openalex.org/keywords/paraneoplastic-syndrome","display_name":"paraneoplastic syndrome","score":0.8989999890327454},{"id":"https://openalex.org/keywords/mediastinal-mass","display_name":"mediastinal mass","score":0.8399999737739563},{"id":"https://openalex.org/keywords/rituximab","display_name":"rituximab","score":0.8560000061988831},{"id":"https://openalex.org/keywords/proteinuria","display_name":"proteinuria","score":0.6200000047683716},{"id":"https://openalex.org/keywords/autoimmune-blistering-disease","display_name":"autoimmune blistering disease","score":0.6710000038146973},{"id":"https://openalex.org/keywords/autoimmune-neuromuscular-disorder","display_name":"autoimmune neuromuscular disease","score":0.49900001287460327},{"id":"https://openalex.org/keywords/kidney-biopsy","display_name":"renal biopsy","score":0.4880000054836273},{"id":"https://openalex.org/keywords/double-stranded-dna","display_name":"double-stranded DNA","score":0.5429999828338623},{"id":"https://openalex.org/keywords/plasmapheresis","display_name":"plasmapheresis","score":0.6909999847412109},{"id":"https://openalex.org/keywords/immunosuppressive-therapy","display_name":"immunosuppressive therapy","score":0.6230000257492065}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.878600001335144},{"id":"https://openalex.org/C2778105408","wikidata":"https://www.wikidata.org/wiki/Q8285","display_name":"Myasthenia gravis","level":2,"score":0.7472000122070312},{"id":"https://openalex.org/C2775934546","wikidata":"https://www.wikidata.org/wiki/Q179991","display_name":"Biopsy","level":2,"score":0.6528000235557556},{"id":"https://openalex.org/C2775946357","wikidata":"https://www.wikidata.org/wiki/Q1713037","display_name":"Membranous nephropathy","level":4,"score":0.6481000185012817},{"id":"https://openalex.org/C2779561371","wikidata":"https://www.wikidata.org/wiki/Q570197","display_name":"Proteinuria","level":3,"score":0.5424000024795532},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.5217999815940857},{"id":"https://openalex.org/C2781087799","wikidata":"https://www.wikidata.org/wiki/Q7312483","display_name":"Renal biopsy","level":3,"score":0.5212000012397766},{"id":"https://openalex.org/C2779159893","wikidata":"https://www.wikidata.org/wiki/Q1429863","display_name":"Thymoma","level":2,"score":0.4620000123977661},{"id":"https://openalex.org/C2780368995","wikidata":"https://www.wikidata.org/wiki/Q605006","display_name":"Glomerulonephritis","level":3,"score":0.42329999804496765},{"id":"https://openalex.org/C2780091579","wikidata":"https://www.wikidata.org/wiki/Q9377","display_name":"Kidney","level":2,"score":0.4162999987602234},{"id":"https://openalex.org/C159641895","wikidata":"https://www.wikidata.org/wiki/Q108377937","display_name":"Renal function","level":2,"score":0.4043000042438507},{"id":"https://openalex.org/C2778930706","wikidata":"https://www.wikidata.org/wiki/Q504790","display_name":"Nephrotic syndrome","level":2,"score":0.38580000400543213},{"id":"https://openalex.org/C2779615886","wikidata":"https://www.wikidata.org/wiki/Q3090790","display_name":"Thymectomy","level":3,"score":0.37139999866485596},{"id":"https://openalex.org/C2778653478","wikidata":"https://www.wikidata.org/wiki/Q1054718","display_name":"Kidney disease","level":2,"score":0.36329999566078186},{"id":"https://openalex.org/C2781184683","wikidata":"https://www.wikidata.org/wiki/Q1054718","display_name":"Nephropathy","level":3,"score":0.3617999851703644},{"id":"https://openalex.org/C2780439664","wikidata":"https://www.wikidata.org/wiki/Q7535376","display_name":"Skin biopsy","level":3,"score":0.35519999265670776},{"id":"https://openalex.org/C544855455","wikidata":"https://www.wikidata.org/wiki/Q1070952","display_name":"Histopathology","level":2,"score":0.3361000120639801},{"id":"https://openalex.org/C16005928","wikidata":"https://www.wikidata.org/wiki/Q171171","display_name":"Dermatology","level":1,"score":0.3172000050544739},{"id":"https://openalex.org/C2778720950","wikidata":"https://www.wikidata.org/wiki/Q424972","display_name":"Prednisone","level":2,"score":0.3018999993801117},{"id":"https://openalex.org/C2779075594","wikidata":"https://www.wikidata.org/wiki/Q8084905","display_name":"Autoimmune disease","level":3,"score":0.2989000082015991},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.2980000078678131},{"id":"https://openalex.org/C2778256501","wikidata":"https://www.wikidata.org/wiki/Q223911","display_name":"Sarcoma","level":2,"score":0.2879999876022339},{"id":"https://openalex.org/C2778842783","wikidata":"https://www.wikidata.org/wiki/Q603502","display_name":"Plasmapheresis","level":3,"score":0.2808000147342682},{"id":"https://openalex.org/C2908662681","wikidata":"https://www.wikidata.org/wiki/Q1534492","display_name":"Microscopic hematuria","level":4,"score":0.273499995470047},{"id":"https://openalex.org/C2781313415","wikidata":"https://www.wikidata.org/wiki/Q3899001","display_name":"Pemphigus vulgaris","level":2,"score":0.265500009059906},{"id":"https://openalex.org/C81182388","wikidata":"https://www.wikidata.org/wiki/Q353963","display_name":"Complication","level":2,"score":0.2628999948501587},{"id":"https://openalex.org/C3018028637","wikidata":"https://www.wikidata.org/wiki/Q4271422","display_name":"Mediastinal mass","level":2,"score":0.26089999079704285},{"id":"https://openalex.org/C2780252810","wikidata":"https://www.wikidata.org/wiki/Q1455316","display_name":"Immunosuppression","level":2,"score":0.2581999897956848},{"id":"https://openalex.org/C2776912625","wikidata":"https://www.wikidata.org/wiki/Q1485","display_name":"Systemic lupus erythematosus","level":3,"score":0.2581000030040741}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1681/asn.2025hmq3x872","doi":"https://doi.org/10.1681/asn.2025hmq3x872","is_oa":false,"landing_page_url":"https://doi.org/10.1681/asn.2025hmq3x872","pdf_url":null,"source":{"id":"https://openalex.org/S115693375","display_name":"Journal of the American Society of Nephrology","issn_l":"1046-6673","issn":["1046-6673","1533-3450"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","doyens","jufo-3","ki-jl-3","medline","norway-2"],"host_organization":"https://openalex.org/P4310315620","host_organization_name":"American Society of Nephrology","host_organization_lineage":["https://openalex.org/P4310315620"],"host_organization_lineage_names":["American Society of Nephrology"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Society of Nephrology","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","score":0.9940000176429749,"id":"https://metadata.un.org/sdg/3"}],"sustainable_development_goals_aurora":[],"study_designs":[{"display_name":"Case Report","id":"https://openalex.org/study-designs/case-report"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":[],"abstract_inverted_index":{"Introduction:":[0],"Follicular":[1],"dendritic":[2],"cell":[3],"sarcoma":[4],"(FDCS)":[5],"is":[6,23,36,244,266],"extremely":[7],"rare":[8,25,54,248],"and":[9,59,111,147,170,201,242,247,303,340,346],"very":[10],"scarce":[11],"in":[12,80,132,238,293],"the":[13,260,269,281,318,326,354,359,362],"mediastinum,":[14],"with":[15,31,44,62,74,103,125,142,256,298,311,320],"only":[16,273,308],"few":[17,275],"cases":[18,276,289,294],"reported.":[19],"Pemphigus":[20],"Vulgaris":[21],"(PV)":[22],"a":[24,37,49,53,88,245,274],"autoimmune":[26,251],"blistering":[27],"disease,":[28],"rarely":[29],"associated":[30,255],"FDCS.":[32,121],"Myasthenia":[33,76],"Gravis":[34],"(MG)":[35],"neuromuscular":[38],"disorder":[39],"that":[40,153,183,306],"can":[41,253],"occur":[42],"concomitantly":[43],"PV.":[45],"Here":[46],"we":[47],"present":[48],"unique":[50],"case":[51],"of":[52,145,150,210,220,262,277,284,290,295],"mediastinal":[55,89],"FDCS,":[56,285],"paraneoplastic":[57,235,278,327],"PV":[58,233,279,296],"MG":[60,99,241,334],"along":[61],"secondary":[63,211,257,350],"membranous":[64],"nephropathy":[65],"(MN)":[66],"Case":[67],"Description:":[68],"52":[69,227],"year":[70],"old":[71],"female":[72],"diagnosed":[73],"oculo-muscular":[75],"gravis":[77],"(ACh-R":[78],"ab+)":[79],"3/2022,":[81],"during":[82],"workup":[83],"was":[84,155,195,335],"found":[85,156],"to":[86,157,240,337],"have":[87,158],"mass,":[90],"no":[91],"thymic":[92],"mass":[93,115],"seen.":[94],"In":[95,268,313],"8/2022":[96],"hospitalized":[97],"for":[98,139,189],"crisis,":[100],"successfully":[101],"treated":[102,141,297],"pyridostigmine,":[104],"prednisone,":[105],"plasmapheresis,":[106],"eventually":[107],"started":[108],"on":[109,117,204],"MMF":[110],"IVIG":[112],"therapy.":[113],"s/p":[114],"resection":[116,322],"5/2023,":[118],"biopsy":[119,137,182,215],"showed":[120,184],"On":[122,177],"9/2023":[123],"complicated":[124],"severe":[126],"stomatitis,":[127],"bullae":[128],"like":[129],"skin":[130,136],"lesions":[131],"whole":[133],"body,":[134],"underwent":[135,180],"positive":[138,168],"PV,":[140],"4":[143],"cycles":[144],"PLEX,":[146],"2":[148,217,331],"doses":[149,219],"Rituximab,":[151],"at":[152],"time":[154],"nephrotic":[159],"proteinuria":[160,224,348],"UACR":[161,226],"5,573":[162],"mg/g,":[163,166,228],"UPCR":[164,229],"8,926":[165],"ANA":[167],"1:320":[169],"dsDNA":[171],"positive,":[172],"kidney":[173,181,214],"function":[174],"remained":[175],"stable.":[176],"6/28/":[178],"2024":[179],"early":[185],"MN,":[186,258],"IF":[187],"negative":[188],"full":[190],"house,":[191],"Class":[192],"V":[193],"LN":[194],"ruled":[196],"out.":[197],"Serum":[198],"PLA2R":[199],"titers":[200],"PLA2R,":[202],"THSDA7":[203],"glomerular":[205],"tissue":[206],"were":[207],"negative,":[208],"suggestive":[209],"MN.":[212],"After":[213],"completed":[216],"more":[218],"rituximab,":[221],"after":[222,309,341],"which":[223,356],"improved,":[225,352],"165":[230],"mg/g":[231],"Discussion:":[232],"as":[234,280],"syndrome,":[236],"specifically":[237],"relation":[239],"FDCS":[243],"complex":[246],"condition.":[249],"Both":[250],"conditions,":[252,328],"be":[254],"yet":[259],"co-occurrence":[261],"these":[263],"3":[264],"conditions":[265,345],"unusual.":[267],"literature":[270],"there":[271,286],"are":[272],"first":[282],"presentation":[283],"has":[287],"been":[288],"refractory":[291,336],"MN":[292,329,351],"standard":[299,338],"therapy":[300],"(steroids+":[301],"MM":[302],"later":[304],"azathioprine)":[305],"improves":[307],"treatment":[310],"Rituximab.":[312],"this":[314],"particular":[315],"case,":[316],"treating":[317],"cancer":[319],"surgical":[321],"did":[323],"not":[324],"resolve":[325],"developed":[330],"years":[332],"after,":[333],"treatment,":[339],"Rituximab":[342],"infusions,":[343],"Paraneoplastic":[344],"Nephrotic":[347],"from":[349],"highlighting":[353],"question,":[355],"came":[357],"first,":[358],"chicken":[360],"or":[361],"egg?":[363]},"counts_by_year":[{"year":2026,"cited_by_count":1}],"updated_date":"2026-10-07T09:51:55.459714","created_date":"2025-12-01T00:00:00"}