Membranöz Nefropatide Yanlış Pozitif Hepatit A IgM: Bir Tedavi İkilemi

Membranous nephropathy (MN) is a primary cause of nephrotic syndrome in adults, often linked to antibodies against M-type phospholipase A2 receptor (PLA2R). Immunosuppressive therapy, such as rituximab and calcineurin inhibitors, is utilized for high-risk patients. This case report discusses a 74-year-old female with anti-PLA2R-positive MN, whose treatment was delayed due to a false-positive hepatitis A virus (HAV)-IgM result. Despite asymptomatic presentation and normal liver function, concerns about potential viral reactivation complicated clinical decisions. After a month of monitoring, immunosuppressive treatment was initiated, and the patient’s proteinuria achieved remission. This case underscores the importance of thorough evaluation of serological results, especially in cases where viral markers could influence critical treatment decisions. The risk of delaying MN treatment must be balanced against the potential dangers of initiating therapy under uncertain viral infection status.