Celiac Disease as a Rare Cause of Membranous Nephropathy: A Case Report

Abstract

Membranous nephropathy is the most common cause of nephrotic syndrome in adults. A non-negligible number of cases are associated with systemic conditions. We report a case of a 50-year-old man who presented with nephrotic syndrome six months after being diagnosed with celiac disease. Although the patient showed disappearance of circulating immunoglobulin A (IgA) anti-tissue transglutaminase antibodies following a gluten-free diet, he had a sudden onset of nephrotic syndrome presenting with severe hypoalbuminemia. Other secondary causes were promptly excluded leading to the assumption of celiac disease-associated membranous nephropathy with remission after treatment with angiotensin system blockade and a gluten-free diet. The goal of this case report is to alert the clinic towards this rare association aiming for an early diagnosis and adequate selection of long-term therapy.

Unraveling chronic kidney disease in children: a surprising manifestation of celiac disease

“…Mukta Mantan et al cited a 2007 study from the Mario Negri Institute for Pharmacological Research in Milan, Italy, which examined the relationship between bread consumption and the risk of kidney cancer. Individuals with the highest bread consumption had a 94% greater likelihood of developing kidney cancer than those with the lowest bread consumption ( 66 ).…”

How to Choose the Right Treatment for Membranous Nephropathy

“…However, in patients with myasthenia gravis and MN, treatment options include steroids, ACTH (which has been shown to achieve partial remission), RTX and, finally, thymectomy [97]. If celiac disease is the underlying cause, a trial of a gluten-free diet plus supportive therapy may lead to proteinuria remission, as described by Pestana et al [98]. Several cases of MN secondary to tuberculosis agents, such as Mycobacterium tuberculosis and the much rarer Mycobacterium shimoidei, have been described without overt renal tuberculosis.…”