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The following is a summary of “Bucillamine-induced membranous nephropathy versus primary membranous nephropathy: comparing pathological features and kidney prognosis,” published in the March 2025 issue of Scientific Reports by Sawa et al.  

Researchers conducted a retrospective study to compare pathological and clinical differences between bucillamine-induced membranous nephropathy (BCL-MN) and primary membranous nephropathy (p-MN). 

They conducted a retrospective study on 29 BCL-MN and 98 patients with p-MN at 2 hospitals from 2000 to 2019, comparing kidney biopsy findings, proteinuria relapse rates, and a 30% or greater decrease in eGFR. 

The results showed similar kidney function and proteinuria levels but histopathological differences. The BCL-MN had less spike formation in light microscopy (LM), more stage I cases, predominant IgG1 (vs IgG4 in p-MN), and higher segmental subepithelial (66.7% vs. 24.7%, P < 0.001) and para-mesangial deposits (61.5% vs 18.1%, P < 0.001). Foot process effacement without dense deposits was more common in BCL-MN (96.3% vs 4.6%, P < 0.001). Most patients with BCL-MN had proteinuria resolution after 1 year of drug discontinuation, with no renal function decline. 

They found that BCL-MN differed from p-MN histologically and clinically, with distinct pathological features and better clinical outcomes, possibly due to the mechanism induced by BCL. 

Source: nature.com/articles/s41598-025-92465-z