A case of membranous nephropathy associated with thyroid antigens.

Iwaoka, Taisuke; Umeda, Teruhisa; Nakayama, Mahito; Shimada, Tatsuya; Fujii, Yoshitaka; Miura, Fumihiro; Satô, Tatsuo

doi:10.2169/internalmedicine1962.21.29

Cited by 13 publications

(10 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To date, only thyroglobulin has been demonstrated to stain positively in membranous nephropathy due to Graves' disease [3][4][5][6], and our present case and that from Shima et al are the only two that report staining for both the TPO antigen and the thyroglobulin antigen [7]. Interestingly, thyroglobulin and TPO antigen deposition in the kidneys has been previously reported in Hashimoto's disease; in these reports, deposits of both thyroglobulin and TPO antigens were seen with the fluorescent antibody technique [9,10]. In contrast, both our group and Shima et al [7] found only TPO antigen deposits, with no deposits of the thyroglobulin antigen in Graves' disease.…”

Section: Discussionsupporting

confidence: 70%

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

et al. 2013

View full text Add to dashboard Cite

A 40-year-old woman was diagnosed with Graves' disease in 2001 and treated with thiamazole, but disease control was poor. She was referred to our hospital in 2011 for exacerbation of proteinuria, which had been present since 2006. Urinalysis showed a protein/creatinine ratio of 4.2 g/gCre and microhematuria, and a renal biopsy was performed. On electron microscopy, high electron density deposits were seen on the epithelial side of the glomerular basement membrane. IgG was also deposited along the glomerular loop wall, and membranous nephropathy was diagnosed. Immunostaining revealed thyroid peroxidase deposits but not thyroglobulin antigen deposits, suggesting that the membranous nephropathy was secondary to Graves' disease. The membranous nephropathy improved with 131 I treatment. To our knowledge, this is the first adult case of membranous nephropathy originating from Graves' disease in which deposits of thyroid peroxidase antigens have been detected.

show abstract

Section: Discussionsupporting

confidence: 70%

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

et al. 2013

View full text Add to dashboard Cite

show abstract

“…One is anti-neutrophil cytoplasmic antibody (ANCA)-positive crescentic glomerulonephritis as a complication of treatment with propylthiouracil [4,5]. The other is MN associated with autoimmune thyroid diseases, such as Hashimoto's and Graves' diseases, in which a considerable proportion of patients have thyroid-associated antigens, such as thyroglobulin and TPO [6][7][8][9][10][11][12][13][14][15]. In the latter condition, the development of MN may be associated with administration of 131 I [8,14].…”

Section: Discussionmentioning

confidence: 99%

“…The release of thyroidassociated antigens, such as thyroglobulin, from the thyroid may ultimately lead to MN [6][7][8][9][10][11][12][13][14][15]. It is believed that 131 I therapy may cause MN as a result of antigens released from the ablated thyroid tissue [8,14].…”

Section: Discussionmentioning

confidence: 99%

Membranous nephropathy associated with thyroid-peroxidase antigen

et al. 2009

View full text Add to dashboard Cite

A 6-year-old previously healthy Japanese girl was found to have dipstick 2+ proteinuria and a goiter based on the results of a routine school medical examination. Her serum free-thyroxine level was 4.98 ng/dL (normal range 0.95-1.74 ng/dL), thyroid-stimulating hormone (TSH) was less than 0.003 microU/mL (0.34-3.88 microU/mL), anti-microsomal (anti-thyroid-peroxidase) antibody was 1600 T (up to 100), anti-thyroglobulin antibody was 400 T (up to 100), and TSH-receptor antibody was 84% (up to +/-10%). These results are consistent with a diagnosis of Graves' disease. Electron microscopy examination of a renal biopsy specimen revealed electron-dense deposits located in the subepithelial spaces, and immunofluorescence microscopy examination demonstrated bright granular stainings of immunoglobulin G along the glomerular capillary walls. These findings are characteristic of membranous nephropathy. To investigate the relationship between the membranous nephropathy and Graves' disease, we carried out a second immunofluorescence study, which revealed that the immunoglobulin G granular deposits corresponded to glomerular granular staining of thyroid-peroxidase, whereas staining for thyroglobulin was absent. It was therefore assumed that the deposition of immune complexes mediated by thyroid-peroxidase had caused the membranous nephropathy in this patient. This is the first report of membranous nephropathy associated with Graves' disease in which deposits of thyroid-peroxidase, rather than thyroglobulin, have been confirmed in the kidney.

show abstract

Section: Glomerular Diseasementioning

confidence: 99%

“…Both hypothyroidism (56) and hyperthyroidism (57,58) can coincide with different forms of glomerular disease. The more frequent form is membranous glomerulopathy associated with nephrotic syndrome (NS) (50,52,(55)(56)(57)59). Thyroid dysfunction has been reported to be associated with IgA glomerulonephritis (49,51,60), mesangiocapillary or membranoproliferative glomerulonephritis (47, 48,61), and minimal change glomerulonephritis (58,59,62,63).…”

Section: Glomerular Diseasementioning

confidence: 99%

Thyroid dysfunction and kidney disease

Iglesias

Díez

2009

European Journal of Endocrinology

373

352

View full text Add to dashboard Cite

Thyroid hormones (TH) are essential for an adequate growth and development of the kidney. Conversely, the kidney is not only an organ for metabolism and elimination of TH, but also a target organ of some of the iodothyronines' actions. Thyroid dysfunction causes remarkable changes in glomerular and tubular functions and electrolyte and water homeostasis. Hypothyroidism is accompanied by a decrease in glomerular filtration, hyponatremia, and an alteration of the ability for water excretion. Excessive levels of TH generate an increase in glomerular filtration rate and renal plasma flow. Renal disease, in turn, leads to significant changes in thyroid function. The association of different types of glomerulopathies with both hyper-and hypofunction of the thyroid has been reported. Less frequently, tubulointerstitial disease has been associated with functional thyroid disorders. Nephrotic syndrome is accompanied by changes in the concentrations of TH due primarily to loss of protein in the urine. Acute kidney injury and chronic kidney disease are accompanied by notable effects on the hypothalamus-pituitary-thyroid axis. The secretion of pituitary thyrotropin (TSH) is impaired in uremia. Contrary to other non-thyroidal chronic disease, in uraemic patients it is not unusual to observe the sick euthyroid syndrome with low serum triodothyronine (T 3 ) without elevation of reverse T 3 (rT 3 ). Some authors have reported associations between thyroid cancer and kidney tumors and each of these organs can develop metastases into the other. Finally, data from recent research suggest that TH, especially T 3 , can be considered as a marker for survival in patients with kidney disease.

show abstract

A case of membranous nephropathy associated with thyroid antigens.

Abstract: A 54-year-old womanwho had proteinuria due to stage II membranous nephropathy is reported. She was treated with indomethacin for proteinuria and developed drug-induced

Cited by 13 publications

References 8 publications

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

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

Membranous nephropathy associated with thyroid-peroxidase antigen

Thyroid dysfunction and kidney disease

Contact Info

Product

Resources

About