A 49-year-old Hispanic male presented to the Emergency Department with progressively worsening swelling in his extremities for the past two months. Physical examination was significant for diffuse
edema, with concomitant initial laboratory tests revealing
hypoalbuminemia,
hypercholesteremia, and
proteinuria. A renal biopsy was performed, and the histopathology confirmed a diagnosis of
membranous nephropathy through immunofluorescence and electron microscopy. Anti-
phospholipase A2 receptor (anti-PLA2R)
antibodies were detected on immunofluorescence, as well as high levels being discovered in the patient's serum, indicating a diagnosis of primary
membranous nephropathy. The patient underwent adequate diuresis and was discharged. The patient presented six months later due to severe
anasarca with laboratory tests indicating a rapid decline in renal function. He was then started on immunosuppressive therapy. Our rare case of a Hispanic male presenting with rapidly deteriorating renal function secondary to primary
membranous nephropathy seeks to highlight the possibility of using anti-PLA2R
antibodies as a marker for early initiation of immunosuppressive therapy as well as to encourage additional research on the course of
disease progression in the Hispanic population.