{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T07:44:19Z","timestamp":1768031059627,"version":"3.49.0"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In primary membranoproliferative glomerulonephritis (MPGN), mesangial and capillary proliferation manifests as a diffuse, spherical change; in secondary MPGN, lesions are predominantly focal and segmental.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>A 52-year-old woman with a 2-year history of primary Sj\u00f6gren\u2019s Syndrome (pSS) and no prior renal involvement developed fever, nephrotic syndrome, and acute kidney injury with oliguria after a pulmonary infection. Her highest recorded serum creatinine level was 327.3 \u00b5mol\/L, and the lowest serum albumin level was 22.1 g\/L. Laboratory findings included an antinuclear antibody titer of 1:320, anti-SSA\/52KD antibody positivity, complement C3 of 0.468 g\/L, complement C4 of 0.0107 g\/L, and rheumatoid factor (RF) 678 IU\/mL. The highest 24-hour urinary protein quantification reached 9.78 g\/24h. After anti-infective treatment, urine output gradually increased, and edema resolved. Cryoglobulin testing showed type II cryoglobulin positivity. Light microscopy revealed MPGN-like lesions in 66.7% of glomeruli and mesangial proliferative glomerulonephritis-like lesions in 25%. Final diagnosis was MPGN. Cyclophosphamide and methylprednisolone were administered. After 30 months follow-up, the patient\u2019s serum creatinine level was 82.1 \u00b5mol\/L; proteinuria was negative.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This case represents the first reported instance of non-diffuse MPGN with cryoglobulinemic GN secondary to pSS. Infection may serve as a key factor in exacerbating cryoglobulinemia and triggering cryoglobulinemic GN onset.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2025.1610017","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T05:17:47Z","timestamp":1748236667000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Primary Sj\u00f6gren\u2019s syndrome presenting with non-diffuse membranoproliferative glomerulonephritis-like lesions in cryoglobulinemic glomerulonephritis: a case 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