Secondary Membranous Nephropathy - One Center Experience

Rihova, Zuzana; Honsová, Eva; Merta, M; Jančová, Eva; Ryšavá, R; Reiterová, Jana; Zabka, J; Tesař, Vladimı́r

doi:10.1081/jdi-200065304

Cited by 23 publications

(23 citation statements)

References 21 publications

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“…This result is in accordance with the findings reported by other authors. 5,8 These studies have also shown that the histological type of cancer and proteinuria may have an important role in activate circulating tumor cells.…”

Section: Discussionmentioning

confidence: 99%

“…This discrepancy might be related to different pathogenic mechanisms. Rihova,5 reported that malignant tumors associated MGN, might be caused by the production of antibodies against tumor cells deposition immune complexes and glomerular deposits. In the same way, Lefaucheur,8 hypothesized that tumorrelated glomerular injury might be related to the inflammatory cells evoked by the tumor.…”

Section: Discussionmentioning

confidence: 99%

“…3,[18][19][20][21][22][23] In addition, some studies suggested that the tumor's recurrence is often accompanied by proteinuria and clinical resolution or recurrence of proteinuria is directly correlated with tumor activity. 5,8,11,12,17 Although a temporal relationship between these two events has been suggested, the pathophysiological mechanisms involved in these cases are not clear. 5,8,9,[11][12][13]15,17,[22][23][24] The aim of this study was to assess the frequency of glomerular disorders in patients dying with malignancy and submitted to autopsy.…”

Section: Introductionmentioning

confidence: 99%

“…5,8,11,12,17 Although a temporal relationship between these two events has been suggested, the pathophysiological mechanisms involved in these cases are not clear. 5,8,9,[11][12][13]15,17,[22][23][24] The aim of this study was to assess the frequency of glomerular disorders in patients dying with malignancy and submitted to autopsy.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5] Membranous glomerulonephritis (MGN) is a condition characterized by the thickening of the membrane of glomerular capillary loops and is the most frequent cause of nephrotic syndrome in adults. [6][7][8] Immunopathological and electron microscopy studies in these patients suggest an immune complex pathogenesis for this disease.…”

Section: Introductionmentioning

confidence: 99%

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Renal glomerular alterations in patients with cancer: a clinical and immunohistochemical autopsy study

et al. 2010

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Background: Membranous glomerulonephritis (MGN) can be found in patients with cancer as a paraneoplastic syndrome or it could be manifested clinically before tumor detection. The aim of this study was to evaluate the frequency and type of renal histopathological alterations in patients with malignancy that died without cancer treatment and were submitted to necropsy. Methods: Patient's demographical and clinical data collection and laboratory tests (serum creatinine and urine sample) were evaluated. Results: Kidney fragments from 21 patients were obtained and studied by light microscopy after habitual staining. Immunohistochemistry studies were performed with monoclonal immunoglobulin and tumor markers. Patients' mean age was 71 years and 62% were male. The most frequent tumor was gastric cancer (five cases), followed by colon and oral cavity (three cases each). In 67% of the cases, malignancy was the main cause of death. Serum creatinine was increased in 10 cases, proteinuria in 15, and hematuria was present in 8 cases. The most usual glomerular lesion found was thickening of basement membrane (BM) of the capillary loops. There were two cases of IgA nephropathy, three cases of focal segmental glomerulosclerosis, and one case of MGN. Only in the patient with MGN and metastatic melanoma specific tumor markers were identified in the kidney. Conclusions: We observed a wide range of glomerular pathological changes and abnormal urinary sediments in almost all patients, but we found tumor marker deposits only in the patient with MGN.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Renal glomerular alterations in patients with cancer: a clinical and immunohistochemical autopsy study

et al. 2010

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Nephrotic syndrome as a clinical manifestation of systemic sclerosis

et al. 2007

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We have described the unusual case of coexistence of membranous nephropathy resulting in nephrotic syndrome with systemic sclerosis. A 60-year-old patient was admitted to the Department of Nephrology with marked proteinuria and oedema. The renal biopsy specimen disclosed the features characteristic of membranous glomerulonephritis. The patient was treated with chlorambucil for 1 month followed by prednisone for 1 month. However, her condition still did not improve. Therefore, the other causes of nephrotic syndrome were investigated. Once anti-Scl-70 antibody was detected the patient was transferred to the Department of Rheumatology and Connective Tissue Diseases. Physical examination revealed Raynaud phenomenon, sclerodactylia, thickened skin of the chest and back. The patient was diagnosed with diffuse systemic sclerosis. The cyclophosphamide therapy was instituted and the patient's condition improved.

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A case of denosumab-associated membranous nephropathy in a patient with rheumatoid arthritis

et al. 2019

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We herein report a case of anti-RANKL monoclonal antibody-associated membranous nephropathy (MN). A 67-year-old woman with a history of rheumatoid arthritis treated with prednisolone and methotrexate for more than 30 years and osteoporosis treated with eldecalcitol and teriparatide for 4 years had achieved a stable disease condition. Her kidney function was normal and her urinalysis was negative for hematuria and proteinuria. An anti-RANKL monoclonal antibody (denosumab) was administered for the treatment of osteoporosis. Four months later, proteinuria appeared (2.3 g/g creatinine) and remained positive for about 6 months, therefore, she was admitted to our hospital. An immunofluorescence study revealed fine granular deposits of immunoglobulin G (IgG) and C3 along the capillary walls. Staining for IgG subclasses showed positive staining for IgG1 (3+), IgG2 (1+), IgG3 (1+), and IgG4 (1+); phospholipase A2 receptor was negative. Electron microscopy showed partial subepithelial and intramembranous deposits and focal thickening of the glomerular basement membrane. No evidence of malignancy or infectious disease was seen. After cessation of denosumab, the proteinuria gradually improved. Based on the renal biopsy results and clinical course (development of marked proteinuria in the presence of denosumab with subsequent amelioration in the absence of the drug), we diagnosed the patient with secondary MN due to denosumab. This is the first reported case of denosumab-associated MN.

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Secondary Membranous Nephropathy - One Center Experience

Abstract: A thorough and repeated exclusion of secondary forms of MN has significant prognostic and therapeutic implications, especially in drug-induced and autoimmune MN.

Cited by 23 publications

References 21 publications

Renal glomerular alterations in patients with cancer: a clinical and immunohistochemical autopsy study

Renal glomerular alterations in patients with cancer: a clinical and immunohistochemical autopsy study

Nephrotic syndrome as a clinical manifestation of systemic sclerosis

A case of denosumab-associated membranous nephropathy in a patient with rheumatoid arthritis

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