Syndrome néphrotique paranéoplasique et cancers broncho-pulmonaires

Menivale, F.; Deslée, G.; Garcia, V.; Sartelet, Hervé; Wynckel, Alain; Lebargy, F.

doi:10.1016/s0761-8425(05)85486-5

Cited by 10 publications

(5 citation statements)

References 12 publications

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“…Membranous nephropathy is an entity frequently associated with neoplastic diseases represented in clinical practice as a nephrotic syndrome [2,3]. It is important to perform an adequate differential diagnosis because the response of paraneoplastic nephrotic syndromes is usually associated with the response to antineoplastic treatment of the oncologic disease.…”

Section: Discussionmentioning

confidence: 99%

Paraneoplastic Membranous Nephropathy in a Patient Diagnosed with Lung Carcinoma in Treatment Immunotherapy: A Case Report and Literature Review

2023

Ann Case Report

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Membranous nephropathy is the most frequent cause of nephrotic syndrome in adults, as well as the most common paraneoplastic syndrome associated with solid tumors. In these cases, it is essential to perform an adequate differential diagnosis since there are multiple causes of this syndrome.We describe the case of a 77-year-old male who presented with heart failure in the context of a nephrotic syndrome with hyponatremia and proteinuria, and was finally diagnosed with locally advanced Squamous Cell Lung Carcinoma (SqNSCLC) (stage IIIB). Renal biopsy confirmed the diagnosis of membranous nephropathy, which in the clinical context of the patient and with the negativity of antiRFLPA2 antibodies was compatible with a nephrotic syndrome of paraneoplastic origin.This was a patient with several comorbidities and poor pulmonary function, which limited the therapeutic options, so radical treatment with concomitant chemoradiotherapy and surgery were ruled out. Molecular analysis of the tumor showed a PD-L1 TPS of 20%, so authorization was requested for the use of first-line immunotherapy with Intravenous (IV) Pembrolizumab every 3 weeks off-label.After initiation of immunotherapy treatment, there was evidence of improvement in the analytical parameters and clinical improvement to the point of resolution of the heart failure. In the first CAT scan evaluation, there was evidence of partial response of the disease, which was maintained until completing two years of treatment, with no evidence of progression until the last oncological consultation. Finally, the patient died due to an exacerbation of COPD while maintaining response of his oncologic disease.

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Section: Discussionmentioning

confidence: 99%

Paraneoplastic Membranous Nephropathy in a Patient Diagnosed with Lung Carcinoma in Treatment Immunotherapy: A Case Report and Literature Review

2023

Ann Case Report

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“…La production d'antigènes tumoraux provoquant la formation de complexes immuns et leur déposition au niveau de la membrane basale glomérulaire auraient pour conséquence l'activation d'un complexe d'attaque membranaire responsable de l'altération de celle-ci [11]. La nature des antigènes produits par les carcinomes bronchiques reste indéterminée [1]. Une autre hypothèse alternative est celle de la formation d'un auto-anticorps produit en réponse contre la tumeur, et qui pourrait avoir une réaction croisée et créer une altération de la membrane basale glomérulaire [12].…”

Section: Discussionunclassified

“…Une autre hypothèse alternative est celle de la formation d'un auto-anticorps produit en réponse contre la tumeur, et qui pourrait avoir une réaction croisée et créer une altération de la membrane basale glomérulaire [12]. Les lésions histologiques sont identiques à celles des GEM idiopathiques mais la présence de polynucléaires neutrophiles dans les anses capillaires semble plus fréquente au cours des GEM paranéoplasiques [1]. De même, il est possible d'observer des thrombus hyalins dans les capillaires.…”

Section: Discussionunclassified

“…Les tumeurs malignes broncho-pulmonaires représentent la première cause du syndrome néphrotique (SN) paranéoplasique [1]. Ces tumeurs sont le plus souvent des carcinomes bronchiques à petites cellules ou des carcinomes épidermoïdes.…”

Section: Introductionunclassified

“…Dans 75 % des cas, le syndrome néphrotique est dû à une glomérulonéphrite extra-membraneuse (GEM). Ce syndrome précède le plus souvent la découverte de la tumeur primitive [1]. Nous rapportons le cas de notre patient, pour mettre le point sur la relation établie entre le syndrome néphrotique paranéoplasique et le carcinome bronchique.…”

Section: Introductionunclassified

See 2 more Smart Citations

Nephrotic Syndrome Revealing of a Squamous Cell Bronchial Carcinoma

Sbiki¹,

Lefqih²,

Taoufiq³

et al. 2022

ATD

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Malignant broncho-pulmonary tumors are the principal cause of the paraneoplastic nephrotic syndrome. These tumors are most often small cell or squamous bronchial carcinomas. In 75% of cases, the nephrotic syndrome is due to membranous glomerulonephritis. We report the case of a 67 years old patient, a chronic tobacco user, followed since June 2019 for a nephrotic syndrome caused by extra-membranous glomerulonephritis. A chest computed tomography revealed a mass of the left lower lobe. Trans-parietal biopsy of this process revealed a squamous bronchial carcinoma. PET scan detected no other fixations. The proteinemia was at 39g/l with albuminemia at 14 g/l. Surgical resection was then indicated and the patient underwent a left lower lobectomy with radical lymph adenectomy. Outcomes were simple with complete resolution of paraneoplastic nephrotic syndrome.

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Renal Parenchymal and Inflammatory Diseases

Quaia

2014

Radiological Imaging of the Kidney

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Syndrome néphrotique paranéoplasique et cancers broncho-pulmonaires

Cited by 10 publications

References 12 publications

Paraneoplastic Membranous Nephropathy in a Patient Diagnosed with Lung Carcinoma in Treatment Immunotherapy: A Case Report and Literature Review

Paraneoplastic Membranous Nephropathy in a Patient Diagnosed with Lung Carcinoma in Treatment Immunotherapy: A Case Report and Literature Review

Nephrotic Syndrome Revealing of a Squamous Cell Bronchial Carcinoma

Renal Parenchymal and Inflammatory Diseases

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