Aetiology of Membranous Glomerulonephritis: A Prospective Study of 82 Adult Patients

Abstract

Eighty-two consecutive Caucasian adults (52 males, 30 females, aged 17-86 years) with membranous glomerulonephritis were prospectively evaluated for possible aetiological factors 1-4 weeks after renal biopsy. Presumed causes were identified in 17 patients (21%) as follows: drugs in five (D-penicillamine 3, captopril 1, fenoprofen 1); malignancy in four; chronic thyroiditis in three; systemic lupus erythematosus (SLE) in two; secondary syphilis in one; hepatitis B virus (HBV) infection in one and non-insulin-dependent diabetes mellitus in one patient. Except for age (patients with secondary membranous glomerulonephritis were older), clinical presentation and histological stage distribution did not differ between the secondary and the primary groups. Ten out of the 17 patients with secondary membranous glomerulonephritis (59%) achieved complete clinical remission within 12 months. The incidence of associated conditions in adults with membranous glomerulonephritis in this study corresponds with that reported in the few previous series. Although membranous glomerulonephritis is deemed to be idiopathic in most cases, it seems warranted to search for medication, malignancy, SLE, HBV infection, syphilis and thyroiditis as possible aetiological factors. Further evaluation should be orientated by the clinical context. An improved outcome of membranous glomerulonephritis may be expected insofar as the underlying condition is controlled.

A case of membranous glomerulopathy associated with lung cancer and review of the literature

“…Another important point stressed in this previous study was that proteinuria decreased with tumor regression. Similarly, in other previous studies, the prevalence of cancer in patients with MN was reported to be 5-22% (11,12).…”

Interaction between PLA2R1 and HLA-DQA1 Variants Associates with Anti-PLA2R Antibodies and Membranous Nephropathy

“…It was reported that membranous nephropathy was much less common in the Chinese population than in the white population. [9][10][11][12][13][14] Although both HLA-DQA1 and PLA2R1 are associated with the development of membranous nephropathy in the Chinese population, PLA2R1 gene variance has shown a much stronger association with the development of IMN as well as the production of anti-PLA2R autoantibodies. In this study, we explored other SNPs in HLA-DOB and HLA-DQB2, which showed a relatively strong signal in European GWAS data; however, only HLA-DQA1 was identified as being associated with membranous nephropathy in the Chinese Han population.…”

“…[9][10][11][12][13][14] In this study, we aim to evaluate the association between these risk alleles and the development of IMN in a large Chinese cohort with .2000 participants and to further explore their roles in the generation of anti-PLA2R antibodies and expression of PLA2R in glomeruli.…”

Membranous Nephropathy Associated With Fluconazole Treatment

“…It usually is idiopathic, and 21% to 25% of cases occur secondary to such identifiable causes as systemic lupus nephritis, malignancies, hepatitis B, and use of drugs. 1 Drugs appear to be the cause of membranous nephropathy in 6% to 9% of cases, and a variety of drugs were reported in association with its development. 1 Gold and penicillamine used in patients with rheumatoid arthritis are typical examples of causative drugs.…”

“…1 Drugs appear to be the cause of membranous nephropathy in 6% to 9% of cases, and a variety of drugs were reported in association with its development. 1 Gold and penicillamine used in patients with rheumatoid arthritis are typical examples of causative drugs. 2,3 Nonsteroidal anti-inflammatory drugs also were implicated in the development of membranous nephropathy.…”