Epithelioid pleural mesothelioma concurrently associated with miliary pulmonary metastases and minimal change nephrotic syndrome – A hitherto undescribed case

Tsukamoto, Yoshitane; Otsuki, Taiichiro; Hao, Hiroyuki; Kuribayashi, Kozo; Nakano, Takashi; Kida, Aritoshi; Nakanishi, Takeshi; Funatsu, Eriko; Noguchi, Chihiro; Yoshihara, Shunya; Kaku, Koji; Hirota, Seiichi

doi:10.1016/j.prp.2015.07.013

Cited by 7 publications

(4 citation statements)

References 31 publications

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“…However, we discuss here the causal relationship between the three events based on the literature as much as possible. We reviewed 15 publications presenting cases of nephrotic syndrome with malignant mesothelioma at various sites [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. Seven cases included information on complement levels, all of which were within the normal range.…”

Section: Discussionmentioning

confidence: 99%

“…Nephrotic syndrome is rarely associated with malignant pleural mesothelioma but is well-known to be induced as a paraneoplastic syndrome [1]. Although not leading to any cohort studies or case series, sporadic cases of nephrotic syndrome associated with malignant mesothelioma have been reported [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. While most cases are assumed to represent nephrotic syndrome secondary to cancer, nephrotic syndrome may develop during the treatment of mesothelioma, and a mechanism speci cally related to chemotherapy has also been postulated [15].…”

Section: Introductionmentioning

confidence: 99%

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Concomitant Nephrotic Syndrome and Cryoglobulinemia in a Case of Malignant Mesothelioma

Nagai

Tachi

Inoue

et al. 2022

Case Reports in Nephrology

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Malignant pleural mesothelioma is rarely associated with nephrotic syndrome. Cryoglobulinemia is found in various pathological statuses, such as hepatitis C virus infection but rarely in malignant neoplasms. We recently encountered a patient with malignant mesothelioma coincident with nephrotic syndrome and cryoglobulinemia in the course of chemotherapy. A 60-year-old man employed as a building painter was diagnosed with malignant mesothelioma by lung biopsy two years earlier and was started on chemotherapy. Nivolumab seemed effective in controlling mesothelioma, but skin immune-related adverse events occurred during the course of treatment. After discontinuation of nivolumab and administration of gemcitabine as an alternative therapy, the patient was referred to a nephrologist because of the subsequent development of edema, renal injury, and proteinuria. Following the investigation, he was diagnosed with nephrotic syndrome and cryoglobulinemia with C4-dominant cold activation. However, a percutaneous renal biopsy could not be performed due to persistent severe cough induced by pleural involvement. The patient died a little over three years after the pathological diagnosis of pleural mesothelioma. Our case had three key features nephrotic syndrome was possibly associated with malignant mesothelioma; cryoglobulinemia occurred in malignant mesothelioma; and concomitant nephrotic syndrome and cryoglobulinemia occurred after chemotherapy. Unfortunately, our rare case lacks a basis in renal pathology or evidence of links between the pathogenesis of malignant mesothelioma, cryoglobulinemia, and nephrotic syndrome. This case does not provide a causal mechanism, but may be worth adding to the case list as one of the rare renal involvement in a patient with malignant mesothelioma.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Concomitant Nephrotic Syndrome and Cryoglobulinemia in a Case of Malignant Mesothelioma

Nagai

Tachi

Inoue

et al. 2022

Case Reports in Nephrology

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“…Patients who developed nephrotic syndrome associated with asbestos-related pulmonary diseases are rare, but eight previous cases have been reported in the English-language literature. Table 2 shows cases of patients with asbestosrelated diseases who developed nephrotic syndrome [10][11][12][13][14][15][16][17]. Most patients had epithelioid mesothelioma, and minimal change disease (MCD) is a common renal pathology.…”

Section: Discussionmentioning

confidence: 99%

Secondary renal amyloidosis associated with asbestos-related pleuropulmonary diseases

et al. 2020

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Here, we present a 67-year-old Japanese man who developed insidious-onset nephrotic syndrome. He had a history of occupational asbestos exposure for about 8 years during his 30s, and was found to have pleural effusion 3 years before his present illness. At that time, repeated cytology testing of his pleural effusion found no malignant cells, and pleural biopsy found fibrous pleuritis without evidence of malignant mesothelioma. Percutaneous kidney biopsy found massive deposits of AA-type amyloid in the glomeruli, small arteries, and medulla. Computed tomography showed a calcified mass in the right lower lung that was positive for 67 Ga uptake, but transbronchial lung biopsy and bronchoalveolar lavage found no evidence of malignancy. He was diagnosed with rounded atelectasis and diffuse pleural thickening. As these benign asbestos-related diseases have no standard treatment, we administered low-dose angiotensin II receptor blocker to preserve kidney function. Unfortunately, his nephrotic syndrome persists, with progressive chronic kidney failure. Kidney involvement in patients with asbestos-related disease is rare. To our knowledge, this is the first case to present with secondary amyloidosis. Kidney biopsy should be considered for patients with existing asbestos-related pleuropulmonary diseases who have urinary abnormalities or renal dysfunction, to clarify the incidence and pathophysiology of renal manifestations.

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“…Most commonly, the glomerular pathology is membranous nephropathy (Da'as, 2001;Farmer, 2001). Renal lesions in the context of MPM are extremely unusual (Venzano, 1990;Tanaka, 1994;Galesic, 2000;Farmer, 2001;Bacchetta, 2009;Suzuki, 2014;Li, 2010;Dogan, 2012;Tsukamoto, 2015;Yildiz, 2016;Shibata, 2020;Xinyu, 2016;Fawole, 2012) with only 12 cases having been reported in the English-language literature (Table 1). Six of the reported cases presented MCD, three with membranous nephropathy, one with proliferative segmental GN and one AA amyloidosis.…”

Section: Published By Scholink Incmentioning

confidence: 99%

Minimal Change Disease Associated with Malignant Epithelioid Mesothelioma: A Case Report

Skondra¹,

Christodoulidou²,

Tegos³

et al. 2021

RHS

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We report the case of a 64 year old male patient with a recent diagnose of pulmonary nodules with pleural thickening who was admitted to the nephrology department of our hospital for further evaluation of nephrotic syndrome (NS). Malignant epithelioid mesothelioma (MEM) was diagnosed after pleural biopsy while the renal biopsy showed minimal change disease (MCD) with acute tubular necrosis and interstitial lymphoplasmacytic infiltrate. MCD is the most common cause of nephrotic syndrome in children while it accounts for a smaller proportion of NS in adults. The underlying cause of MCD is unclear (Cameron, 1987). Evidence so far suggests that T-cell dysfunction results in the production of a circulating factor directly affecting the glomerular capillary wall with consequent foot process fusion. MCD as paraneoplastic syndrome is common in hematological disorder while the incidence in lung pulmonary malignancies is rare. Early recognition leads to an early diagnosis of malignancy improving the outcome and diminishing the associated co-morbidities.

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Epithelioid pleural mesothelioma concurrently associated with miliary pulmonary metastases and minimal change nephrotic syndrome – A hitherto undescribed case

Cited by 7 publications

References 31 publications

Concomitant Nephrotic Syndrome and Cryoglobulinemia in a Case of Malignant Mesothelioma

Concomitant Nephrotic Syndrome and Cryoglobulinemia in a Case of Malignant Mesothelioma

Secondary renal amyloidosis associated with asbestos-related pleuropulmonary diseases

Minimal Change Disease Associated with Malignant Epithelioid Mesothelioma: A Case Report

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