MEMBRANOUS LUPUS NEPHRITIS WITH ANTINEUTROPHIL CYTOPLASMIC ANTIBODY-ASSOCIATED SEGMENTAL NECROTIZING AND CRESCENTIC GLOMERULONEPHRITIS

Focal segmental necrotizing and crescentic lupus nephritis accompanied by perinuclear antineutrophil cytoplasmic antibody (P-ANCA) seroposit ivity is an unusual occurrence. We report the first biopsy-documented cases of membranous lupus nephritis class V with associated ''pauci-im mune'' segmental necrotizing glomerulonephritis and P-ANCA seropositiv ity. The absence of subendothelial electron-dense deposits favored a m anifestation of superimposed ANCA-associated glomerulonephritis rather than class III lupus nephritis, The pathogenetic implications of this association are explored. (C) 1997 by the National Kidney Foundation, Inc.