Immune-Mediated Glomerulonephritis after Exposure to Paraquat

Abstract

Exposure to paraquat was followed 1 week later by mild respiratory distress in a previously healthy farmer who developed a mixed nephrotic/nephritic syndrome 3 months later. Percutaneous renal biopsy showed endo-extra-capillary proliferative glomerulonephritis associated with a linear pattern of IgG deposits along the glomerular capillary wall. This is the first case report of an association between exposure to a low dose of paraquat (as suggested by the mildness of the respiratory symptoms) and development of glomerulonephritis, possibly related to the occurrence of anti-glomerular basement membrane antibodies. The possibility is suggested that immune-mediated mechanisms of glomerular damage may be triggered by exposure to low-dose paraquat.

Unfractionated bone marrow cells attenuate paraquat-induced glomerular injury and acute renal failure by modulating the inflammatory response

“…Many previous studies of PQ-induced nephrotoxicity have focused on the renal tubule, as kidney damage is primarily localized in the proximal tubule. However, PQ exposure has been associated with various glomerular diseases, such as glomerulonephritis 26 . Upon histology examination, glomerular injuries were observed in the PQ-only group, with incomplete Bowman’s capsules and vacuolization in the glomerulus on day 1, which further progressed to glomerular shrinkage and decreased the space between the glomerulus and Bowman’s capsule on day 6.…”

Environmental pollutants parathion, paraquat and bisphenol A show distinct effects towards nuclear receptors-mediated induction of xenobiotics-metabolizing cytochromes P450 in human hepatocytes

“…Thus, the outcomes of the effects of PRQ on immunity are route of exposure-and timingdependent since slight discrepancies are evident between these two studies. Concerning the human exposure, the case report from 1988 associates low-dose paraquat exposure and immunemediated glomerulonephritis (Stratta et al, 1988). Nevertheless, if we want to address PRQ effect on human immune system, there must be extensive studies either in surviving patients or in agricultural workers who come in frequent contact with PRQ as a few case reports involved extensive skin contamination were reported (Hoffer and Taitelman, 1989;Smith, 1988).…”

Antiglomerular Basement Membrane Glomerulonephritis after Inhalation of Chemical Toxins

“…We read with interest the paper from Stratta et al [1] reporting a case of proliferative glomerulonephritis with linear glomerular IgG deposits after inhalation of para quat. The authors state that this is the first case report of such an association.…”