# Anti-phospholipase A2 Receptor Membranous Nephropathy Presenting as Common Geriatric Complaints: A Case Report

## TL;DR

An elderly woman with anti-PLA2R-associated kidney disease showed common aging symptoms, highlighting the need for early diagnosis to protect kidney function.

## Contribution

Highlights atypical presentation of anti-PLA2R MN in elderly patients and successful treatment with rituximab.

## Key findings

- Elderly patient presented with fluid overload and hypoglycaemia instead of typical MN symptoms.
- Rituximab treatment improved renal function and reduced anti-PLA2R antibody levels significantly.

## Abstract

Anti-phospholipase A2 receptor (anti-PLA2R) antibodies are an established cause of primary membranous nephropathy (MN). However, typical symptoms of proteinuria, such as peripheral oedema and frothy urine, are not easily identified in the elderly, and other non-specific presentations, such as hypoglycaemia and fluid overload, may lead to delays in diagnosis.

We report a case of anti-PLA2R-associated MN in an elderly woman who presented with fluid overload and recurrent hypoglycaemia, both of which are common in this age group. Renal function and anti-PLA2R antibody titres improved substantially following treatment with rituximab. This case underscores the importance of early clinical suspicion and timely intervention in elderly patients in order to preserve residual renal function and optimise outcomes.