Membranous nephropathy secondary to Graves’ disease with deposits of thyroid peroxidase in an adult

Sasaki, Koichi; Yasuda, Keiko; Nakanishi, Koichi; Rakugi, Hiromi; Isaka, Yoshitaka; Yamato, Masayuki

doi:10.1007/s13730-013-0093-y

Cited by 10 publications

(7 citation statements)

References 8 publications

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“…The mechanisms linking autoimmune thyroiditis and MN are still poorly defined. However, both in children ( 133 ) and adults ( 134 ) the development of MN is associated with deposition of immune complexes mediated by anti- thyroid-peroxidase antibodies, suggesting that renal disease may be caused by the production of autoantibodies against podocyte antigens. Immunofluorescence examination demonstrates bright granular staining of IgG along the GBM, corresponding to glomerular granular staining of thyroid-peroxidase while no thyroglobulin deposits are present.…”

Section: Membranous Nephropathy Secondary To Immunological and Rheumamentioning

confidence: 99%

Secondary Membranous Nephropathy. A Narrative Review

Moroni

Ponticelli²

2020

Front. Med.

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Membranous nephropathy (MN) is a common cause of proteinuria and nephrotic syndrome all over the world. It can be subdivided into primary and secondary forms. Primary form is an autoimmune disease clinically characterized by nephrotic syndrome and slow progression. It accounts for ~70% cases of MN. In the remaining cases MN may be secondary to well-defined causes, including infections, drugs, cancer, or autoimmune diseases, such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), urticarial vasculitis, sarcoidosis, thyroiditis, Sjogren syndrome, systemic sclerosis, or ankylosing spondylitis. The clinical presentation is similar in primary and secondary MN. However, the outcome may be different, being often related to that of the original disease in secondary MN. Also, the treatment may be different, being targeted to the etiologic cause in secondary MN. Thus, the differential diagnosis between primary and secondary MN is critical and should be based not only on history and clinical features of the patient but also on immunofluorescence and electron microscopy analysis of renal biopsy as well as on the research of circulating antibodies. The identification of the pathologic events underlying a secondary MN is of paramount importance, since the eradication of the etiologic factors may be followed by remission or definitive cure of MN. In this review we report the main diseases and drugs responsible of secondary MN, the outcome and the pathogenesis of renal disease in different settings and the possible treatments.

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Section: Membranous Nephropathy Secondary To Immunological and Rheumamentioning

confidence: 99%

Secondary Membranous Nephropathy. A Narrative Review

Moroni

Ponticelli²

2020

Front. Med.

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“…Previous studies found membranous nephropathy was also the most common pathological type in the autoimmune thyroiditis associated glomerulonephritis [ 10 ]. Both thyroglobulin (TG) and thyroperoxidase (TPO) had been found in the subepithelial immune deposits, as the main characteristic of membranous nephropathy, which may be the reason of the higher prevalence of membranous nephropathy associated with autoimmune thyroid disease [ 18 – 20 ]. Despite all the patients with known thyroid disease were excluded, we found 6/17 (35.3%) patients with thyroid dysfunction had TGAb and/or TPOAb.…”

Section: Discussionmentioning

confidence: 99%

Significance of thyroid dysfunction in the patients with primary membranous nephropathy

Cao

Mao

et al. 2022

BMC Nephrol

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Background Thyroid dysfunction is common in patients with nephrotic syndrome, especially patients with primary membranous nephropathy (pMN). In view of both MN and thyroid dysfunction are associated with autoimmunity, the current study aimed to elucidate the significance of thyroid dysfunction in patients with pMN. Methods Four hundred and twenty patients with biopsy-proven pMN from 2018–2021 were retrospectively enrolled. Clinical and pathological parameters, and treatment response of patients with and without thyroid dysfunction were analyzed. Results Ninety-one (21.7%) patients with pMN suffered from thyroid dysfunction, among which subclinical hypothyroidism (52.7%) was the main disorder. Compared to patients with normal thyroid function, patients with thyroid dysfunction presented with a higher level of proteinuria, a lower level of serum albumin, a higher level of serum creatinine and more severe tubulointerstitial injury at the time of biopsy. But the positive rate and level of circulating anti-phospholipase A2 receptor (PLA2R) antibody were comparable between these two groups. Though following the similar treatment, the percentage of no response to treatment were significantly higher in the patients with thyroid dysfunction (38.6 vs. 20.0%, P = 0.003). Similar to the urinary protein and the positivity of anti-PLA2R antibody, multivariate COX analysis showed thyroid dysfunction was also identified as an independent risk factor for the failure to remission (HR = 1.91, 95%CI, 1.07–3.40, P = 0.029). Conclusion In conclusion, thyroid dysfunction is common in the patients with pMN and might predict a severe clinical manifestation and a poor clinical outcome, which indicated that the thyroid dysfunction might be involved in the disease progression of pMN.

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“…As renal expression of TSH-R was documented, an influence of TSH itself has also been proposed ( 29 ). There are reports of nephritis due to thyroid antigen-antibody complexes in GD ( 98 , 99 ). Despite these phenomena being generally attributed to circulating complexes, in light of the knowledge of TSH-R expression in the kidney, in situ antibody formation can also be considered ( 29 ).…”

Section: Tsh Receptor In Human Diseasementioning

confidence: 99%

“…• Nephritis due to thyroid antigen-antibody complexes in GD (98, 99) ( 28,29,98,99) Liver (mRNA and protein)…”

Section: Author Contributionsmentioning

confidence: 99%

The Mysterious Universe of the TSH Receptor

2022

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The thyroid-stimulating hormone receptor (TSH-R) is predominantly expressed in the basolateral membrane of thyrocytes, where it stimulates almost every aspect of their metabolism. Several extrathyroidal locations of the receptor have been found including: the pituitary, the hypothalamus, and other areas of the central nervous system; the periorbital tissue; the skin; the kidney; the adrenal; the liver; the immune system cells; blood cells and vascular tissues; the adipose tissue; the cardiac and skeletal muscles, and the bone. Although the functionality of the receptor has been demonstrated in most of these tissues, its physiological importance is still a matter of debate. A contribution to several pathological processes is evident in some cases, as is the case of Grave’s disease in its multiple presentations. Conversely, in the context of other thyroid abnormalities, the contribution of the TSH-R and its ligand is still a matter of debate. This article reviews the several different sites of expression of the TSH-R and its potential role in both physiological and pathological processes.

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Membranous nephropathy secondary to Graves’ disease with deposits of thyroid peroxidase in an adult

Cited by 10 publications

References 8 publications

Secondary Membranous Nephropathy. A Narrative Review

Secondary Membranous Nephropathy. A Narrative Review

Significance of thyroid dysfunction in the patients with primary membranous nephropathy

The Mysterious Universe of the TSH Receptor

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