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Peer-reviewedCC BY-NC-ND 4.0BMC Nephrology

The sequential occurrence of Bullous pemphigoid, membranous nephropathy and rheumatoid arthritis: all in one patient, a case report

  • Nadir Suleyman Cetinkaya1
  • Mesudiye Bulut2
  • Buse Hacıoğlu2
  • Aysenur Botsali3
  • Fatih Gökhan Akbay2
  • Bulent Erdoğan2
  • Ertuğrul Çelik4
  • Gülşen Akoğlu3
  • Hadim Akoğlu2
4 affiliations
  1. 1Department of Internal Medicine, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Türkiye Turkey
  2. 2Department of Nephrology, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Türkiye Turkey
  3. 3Department of Dermatology, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Türkiye Turkey
  4. 4Department of Pathology, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Türkiye Turkey
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Abstract

Background: Bullous pemphigoid (BP) is an autoimmune disease of the skin and mucous membranes. The presentation of BP as a multiple autoimmune syndrome has rarely been reported.

Case presentation: We report a 49-year-old man with multiple blistering skin lesions and nephrotic syndrome. Skin-punch and kidney biopsy revealed BP and membranous nephropathy (MN), respectively. Subsequent workup did not reveal a secondary cause for MN. The patient was treated with rituximab and methylprednisolone and his skin lesions and renal disease resolved. Arthritis occurred after discontinuation of the steroid therapy and he was diagnosed with rheumatoid arthritis (RA). The patient started methotrexate treatment, and during the 12-month treatment period, he was free of skin lesions and arthritis with normal kidney function.

Conclusions: This case describes the rare temporal coexistence of BP, MN, and subsequently diagnosed RA. Physicians should be aware of developing an additional autoimmune disease in patients who already have co-existing autoimmune diseases.

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Cite

BibTeXRIS
BibTeX
@article{cetinkaya2026sequential,
  title = {{The sequential occurrence of Bullous pemphigoid, membranous nephropathy and rheumatoid arthritis: all in one patient, a case report}},
  author = {Nadir Suleyman Cetinkaya and Mesudiye Bulut and Buse Hacıoğlu and Aysenur Botsali and Fatih Gökhan Akbay and Bulent Erdoğan and Ertuğrul Çelik and Gülşen Akoğlu and Hadim Akoğlu},
  journal = {BMC Nephrology},
  year = {2026},
  month = aug,
  doi = {10.1186/s12882-026-05262-9},
  url = {https://doi.org/10.1186/s12882-026-05262-9},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - The sequential occurrence of Bullous pemphigoid, membranous nephropathy and rheumatoid arthritis: all in one patient, a case report
AU  - Nadir Suleyman Cetinkaya
AU  - Mesudiye Bulut
AU  - Buse Hacıoğlu
AU  - Aysenur Botsali
AU  - Fatih Gökhan Akbay
AU  - Bulent Erdoğan
AU  - Ertuğrul Çelik
AU  - Gülşen Akoğlu
AU  - Hadim Akoğlu
PY  - 2026
DA  - 2026/08/11
JO  - BMC Nephrology
DO  - 10.1186/s12882-026-05262-9
UR  - https://doi.org/10.1186/s12882-026-05262-9
AB  - Background: Bullous pemphigoid (BP) is an autoimmune disease of the skin and mucous membranes. The presentation of BP as a multiple autoimmune syndrome has rarely been reported.  Case presentation: We report a 49-year-old man with multiple blistering skin lesions and nephrotic syndrome. Skin-punch and kidney biopsy revealed BP and membranous nephropathy (MN), respectively. Subsequent workup did not reveal a secondary cause for MN. The patient was treated with rituximab and methylprednisolone and his skin lesions and renal disease resolved. Arthritis occurred after discontinuation of the steroid therapy and he was diagnosed with rheumatoid arthritis (RA). The patient started methotrexate treatment, and during the 12-month treatment period, he was free of skin lesions and arthritis with normal kidney function.  Conclusions: This case describes the rare temporal coexistence of BP, MN, and subsequently diagnosed RA. Physicians should be aware of developing an additional autoimmune disease in patients who already have co-existing autoimmune diseases.
SN  - 1471-2369
ER  -