Pseudonephrotic Syndrome Caused by Lysozymuria

Mok, Chi Chiu; Tam, Schuman; Kwong, Yok–Lam

doi:10.7326/0003-4819-121-10-199411150-00020

Cited by 9 publications

(4 citation statements)

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“… 10 Despite the proximal tubules’ high absorptive capacity for lysozyme, 11 , 12 marked overproduction of lysozyme in patients with monocytic leukemias may exceed the transport maximum, leading to nephrotic-range nonalbumin proteinuria, as appears to have occurred in this case. 13 , 14 By protein electrophoresis, lysozyme migrates in the gamma (γ) region. Therefore, the presence of nonalbumin proteinuria with an increased γ-globulin fraction but without detectable monoclonal bands by immunofixation electrophoresis may be a useful indicator of lysozymuria in the appropriate clinical context.…”

Section: Discussionmentioning

confidence: 99%

Lysozyme-Induced Nephropathy

Santoriello

Andal

Cox

et al. 2017

Kidney International Reports

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Section: Discussionmentioning

confidence: 99%

Lysozyme-Induced Nephropathy

Santoriello

Andal

Cox

et al. 2017

Kidney International Reports

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“…. Of note, severe monocytosis causes marked lysozymuria, which may present as nephrotic range proteinuria 78. This pseudonephrotic syndrome should be excluded before a diagnosis of paraneoplastic glomerulonephritis is made.…”

Section: Hematological Malignanciesmentioning

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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“…At very high concentrations, lysozyme causes renal tubular damage, resulting in proteinuria and hypokalemia, but renal tubular loss is rarely very high [4]. As to lysozymuria itself as a cause for gross proteinuria, there has been only one report in the literature [5], to the best of our knowledge.A 35-year-old man presented with a 2-week history of visual problems, fever, facial edema, and gingival hypertrophy. His leukocyte count was 38 !…”

mentioning

confidence: 93%