Paraneoplastic Polymyositis Associated with Crescentic Glomerulonephritis

Chiu, Kuan-Chi; Tsai, Tsung‐Chang; Lin, Wei-Tung; Lee, Wei-Jen; Su, Chin-Chuan; Chen, Chen-Yin

doi:10.1080/08860220802353918

Cited by 13 publications

(4 citation statements)

References 12 publications

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“…In the literature search we retrieved 15 published cases 1 , 3 , 4 , 6 , 9 , 14 , 15 , 21 , 22 , 25 – 29 , 31 of nephropathies documented by kidney biopsy in IM patients (Table 6 ). These cases include IgAN (n = 7), MN (n = 1), membranoproliferative glomerulonephritis (n = 1), pauci-immune crescentic glomerulonephritis (n = 2), minimal change disease (n = 2), focal segmental glomerulosclerosis lesions (n = 1), and acute tubulointerstitial nephritis (n = 1).…”

Section: Resultsmentioning

confidence: 99%

The Spectrum of Renal Involvement in Patients With Inflammatory Myopathies

et al. 2014

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Data regarding the incidence and outcome of renal involvement in patients with inflammatory myopathies (IM) remain scarce. We assessed the incidence and causes of acute kidney injury (AKI) and chronic kidney disease (CKD) in 150 patients with dermatomyositis, polymyositis, and antisynthetase syndrome followed in 3 French referral centers. Renal involvement occurred in 35 (23.3%) patients: AKI in 16 (10.7%), and CKD in 31 (20.7%) patients. The main cause of AKI was drug or myoglobinuria-induced acute tubular necrosis. Male sex, cardiovascular risk factors, cardiac involvement, and initial proteinuria >0.3 g/d were associated with the occurrence of AKI. The outcome of patients with AKI was poor: 13 (81%) progressed to CKD and 2 (12.5%) reached end-stage renal disease. In multivariate survival analysis, age at IM onset, male sex, a history of cardiovascular events, and a previous episode of AKI were associated with the risk of CKD. We also identified 14 IM patients who underwent a kidney biopsy in 10 nephrology centers. Renal pathology disclosed a wide range of renal disorders, mainly immune-complex glomerulonephritis. We identified in 5 patients a peculiar pattern of severe acute renal vascular damage consisting mainly of edematous thickening of the intima of arterioles.We found that AKI and CKD are frequent in patients with IM. Prevention of AKI is crucial in these patients, as AKI is a major contributor to their relatively high risk of CKD. A peculiar pattern of acute vascular damage is part of the spectrum of renal diseases associated with IM.

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Section: Resultsmentioning

confidence: 99%

The Spectrum of Renal Involvement in Patients With Inflammatory Myopathies

et al. 2014

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“…4–7 Membranous nephropathy is in general the most commonly reported paraneoplastic glomerulonephritis; MCD, membranoproliferative glomerulonephritis, RPGN and IgA nephropathy have been reported less frequently. Of note, this Figure and subsequent Figures are based on reported cases of paraneoplastic glomerulonephritis and by no means reflect the epidemiology of paraneoplastic glomerulonephritis.…”

Section: Solid Tumorsmentioning

confidence: 99%

Pathogenesis, diagnosis and management of paraneoplastic glomerulonephritis

2010

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Paraneoplastic glomerulonephritis is a rare complication of malignancy that is frequently mistaken for idiopathic glomerulonephritis. Failure to recognize paraneoplastic glomerulonephritis can subject patients to ineffective and potentially harmful therapy. Pathology of paraneoplastic glomerulonephritis varies between different types of malignancies. This Review describes the association of glomerulonephritis with both solid tumors and hematological malignancies The pathogenetic mechanisms of many glomerular lesions seem to relate to altered immune responses in the presence of a malignancy Studies in the Buffalo/Mna rat model of spontaneous thymoma and nephrotic syndrome indicate that polarization of the immune response toward a T-helper-2 (T H 2) profile has an important role in the development of thymoma-associated glomerular lesions. Furthermore, overexpression of the T H 2 cytokine interleukin 13 in transgenic rats induces minimal change disease. Such findings from experimental studies might facilitate the identification of biomarkers that can distinguish paraneoplastic glomerulonephritis from idiopathic and other secondary glomerulonephritides. This Review describes potential pathogenetic mechanisms for paraneoplastic glomerulonephritides associated with different malignancies and highlights the need for a multidisciplinary approach to the management of patients with paraneoplastic glomerulonephritis.

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“…Case reports of PM/DM complicated with IgAN are not common. To date, 11 cases of SAMs with IgAN have been reported previously: two cases of juvenile DM (21,22), two DM (23,24), three PM (25)(26)(27), and four anti-synthetase syndrome (11,13,28). The details of the reported 11 cases are shown in Table 2.…”

Section: Discussionmentioning

confidence: 99%

Case Report: IgA Nephropathy in a Patient With Anti-Transcription Intermediary Factor-1γ Antibody-Positive Dermatomyositis

et al. 2022

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Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis characterized by IgA deposits in the mesangial area of glomeruli. Connective tissue disorders are some of the most frequent causes of secondary IgAN. Nevertheless, IgAN rarely occurs in systemic autoimmune myopathies (SAMs). The present case study reports on a 58-year-old patient with dermatomyositis with positive anti-transcription intermediary factor (TIF)-1γ antibodies who was diagnosed with IgAN during standard immunosuppressive therapy. Moreover, we have made a systematic review regarding the association of SAMs and IgAN. To the best of the authors’ knowledge, this is the first case study describing a patient with anti-TIF1γ antibody-positive dermatomyositis who developed IgAN, which demonstrates a potential relationship between anti-TIF1γ-positive dermatomyositis and IgAN. It is important for clinicians to be aware of the possibility of renal involvement in patients with SAMs, even in those with anti-TIF1γ-positive dermatomyositis.

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Paraneoplastic Polymyositis Associated with Crescentic Glomerulonephritis

Cited by 13 publications

References 12 publications

The Spectrum of Renal Involvement in Patients With Inflammatory Myopathies

The Spectrum of Renal Involvement in Patients With Inflammatory Myopathies

Pathogenesis, diagnosis and management of paraneoplastic glomerulonephritis

Case Report: IgA Nephropathy in a Patient With Anti-Transcription Intermediary Factor-1γ Antibody-Positive Dermatomyositis

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