Membranous Glomerulonephritis and Melanoma: a Causal Correlation?

Carrera, Luis Gómez; Prados, C; Álvarez-Sala, R.; Rio, T. Garcia; Villamor, J.; Martínez-Ara, Jorge

doi:10.1093/jnci/86.1.64-a

Cited by 7 publications

(2 citation statements)

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“…This is consistent with the fact first that skin cancers associated with MN have rarely been reported in the literature, and second that only melanoma, Kaposi's sarcoma or cutaneous T-cell lymphomas have been reported in association with MN. [20][21][22] In our study, the clinical presentation of cancer-associated MN could not be distinguished from that of idiopathic MN, with one noticeable exception; heavy smoking (X20 packyears) was more frequent among patients with cancer. In previous studies of biopsies in malignancy-related MN, efforts have focused on detection of tumor antigens, rather than on comparative studies of potential differences separating such cases from idiopathic MN.…”

Section: Discussionmentioning

confidence: 81%

Membranous nephropathy and cancer: Epidemiologic evidence and determinants of high-risk cancer association

Lefaucheur

Stengel

Nochy

et al. 2006

Kidney International

228

200

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The association between membranous nephropathy (MN) and cancer is often mentioned in textbooks but poorly substantiated, and the characteristics of cancer-associated MN are unknown. To address these questions, we studied a cohort of 240 patients with MN, among them 24 had malignancy at the time of renal biopsy or within a year thereafter. The incidence of cancer was significantly higher in these patients than in the general population (standardized incidence ratio 9.8 [5.5-16.2] for men and 12.3 [4.5-26.9] for women). The frequency of malignancy increased with age. At the time of diagnosis, clinical presentation did not differ between the patients with cancer-associated MN and those with idiopathic MN, but smoking was more frequent among patients with cancer. Analysis of renal biopsies revealed that the number of inflammatory cells infiltrating the glomeruli was significantly higher in patients with cancer-associated MN (P = 0.001). The best cutoff value for distinguishing malignancy-related cases from controls was eight cells per glomerulus. Using this threshold led to a diagnosis of cancer-associated MN with a specificity of 75% and a sensitivity of 92%. In patients with cancer-associated MN, there was a strong relationship between reduction of proteinuria and clinical remission of cancer (P < 0.001). In conclusion, our study provides epidemiologic evidence of an excess of cancer risk in patients with MN. It also shows that age, smoking, and the presence of glomerular leukocytic infiltrates strongly increase the likelihood of malignancy in MN patients.

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Section: Discussionmentioning

confidence: 81%

Membranous nephropathy and cancer: Epidemiologic evidence and determinants of high-risk cancer association

Lefaucheur

Stengel

Nochy

et al. 2006

Kidney International

228

200

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“…The patient's diagnosis of MN and cancer should be temporally associated, proteinuria should resolve with cancer remission, and/or relapse of the malignancy causes recurrence of the MN. Multiple tumor types were identified in temporal association with membranous nephropathy, including carcinomas (58), soft tissue tumors (154), melanoma (155), thymoma (154), and lymphoma (68,156,157). Histopathologic clues for malignancy-associated MN include PLA2R-negativity, a segmental pattern on IgG staining, endocapillary hypercellularity (154), and IgG1 and IgG2predominant immune deposits (as most cases of primary MN have IgG4-predominant immune deposits) (158).…”

Section: Malignancy-associated Membranous Nephropathymentioning

confidence: 99%

How Times Have Changed! A Cornucopia of Antigens for Membranous Nephropathy

2021

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The identification of the major target antigen phospholipase A2 receptor (PLA2R) in the majority of primary (idiopathic) cases of membranous nephropathy (MN) has been followed by the rapid identification of numerous minor antigens that appear to define phenotypically distinct forms of disease. This article serves to review all the known antigens that have been shown to localize to subepithelial deposits in MN, as well as the distinctive characteristics associated with each subtype of MN. We will also shed light on the novel proteomic approaches that have allowed identification of the most recent antigens. The paradigm of an antigen normally expressed on the podocyte cell surface leading to in-situ immune complex formation, complement activation, and subsequent podocyte injury will be discussed and challenged in light of the current repertoire of multiple MN antigens. Since disease phenotypes associated with each individual target antigens can often blur the distinction between primary and secondary disease, we encourage the use of antigen-based classification of membranous nephropathy.

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Membranous Glomerulonephritis, Secondary

2016

Diagnostic Pathology: Kidney Diseases

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Membranous Glomerulonephritis and Melanoma: a Causal Correlation?

Cited by 7 publications

References 0 publications

Membranous nephropathy and cancer: Epidemiologic evidence and determinants of high-risk cancer association

Membranous nephropathy and cancer: Epidemiologic evidence and determinants of high-risk cancer association

How Times Have Changed! A Cornucopia of Antigens for Membranous Nephropathy

Membranous Glomerulonephritis, Secondary

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