Nephrotic syndrome after thymectomy for myasthenia gravis

Kute, VivekB; Shah, PR; Shrimali, J D; Gumber, Manoj R.; Patel, Himanshu V.; Vanikar, Aruna V; Trivedi, Hargovind L

doi:10.4103/0971-4065.107218

Cited by 3 publications

(4 citation statements)

References 3 publications

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“…Of all these 23 cases, [2,3,7–12] almost half of them (11 cases) the MCD had occurred months or years after thymic disease. [1,2] On the contrary, only 6 cases developed thyomoa after the diagnosis of MCD, and 6 cases (including our patient) had the diagnosis of MCD and MG at the same time. Thus, the temporal onset of MCD may or may not be delayed as previously thought.…”

Section: Discussionmentioning

confidence: 66%

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Minimal change disease in a patient with myasthenia gravis

Tsai

2016

Medicine

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Background:Myasthenia gravis superimposed with proteinuria is a very rare disorder with only 39 cases reported so far. Of these cases, the most commonly associated disorder is minimal change disease. Myasthenia gravis and minimal change disease are both related to the dysfunction of T lymphocytes and hence the 2 disorders may be connected.Methods:Here we report the first case on a patient diagnosed with myasthenia gravis concurrently with the minimal change disease, and it was presented in the absence of thymoma or thymic hyperplasia.Results:Treatment for myasthenia gravis also lowered proteinuria of minimal change disease. He ever experienced good control for myasthenia gravis and minimal change disease. However, pneumonia related septic shock occurred to him and finally he was dead. Minimal change disease is generally considered to occur subsequent to the onset of myasthenia gravis with causal association. After extensive literature review, we noted only 47.8% minimal change disease had occurred after the onset of myasthenia gravis.Conclusion:Minimal change disease mostly occurs in children and if diagnosed in adults, clinicians should search for a potential cause such as myasthenia gravis and other associated thymic disorders.

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Section: Discussionmentioning

confidence: 66%

“…But MG superimposed with proteinuria is very rare and there are only 39 cases reported so far. [1–4] Minimal change disease (MCD) [5] and MG are both related to the dysfunction of T lymphocytes and there may exist some connection between the 2 disorders. Here we report an 82-year-old man diagnosed at the same time with MG and MCD.…”

Section: Introductionmentioning

confidence: 99%

Minimal change disease in a patient with myasthenia gravis

Tsai

2016

Medicine

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“…In particular, the subtype thymoma-associated MG can generate various immunological disturbances, including effects on non-motor systems due to T cell malfunctions, which are highly influenced by thymoma. It is important to understand and appropriately treat non-motor complications of MG because these are common clinical immunological disturbances associated with MG. We also summarized previously reported MG cases showing similar non-motor comorbidities in Table (5-9,16-24). Our present cases demonstrated multiple non-motor symptoms, making them significant cases in the consideration of immunological disturbances among MG patients.…”

Section: Discussionmentioning

confidence: 96%

Non-motor Comorbidity of Myasthenia Gravis: Myasthenia Gravis as a Systemic Immunological Disorder Involving Non-motor Systems

2019

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To explore non-motor comorbidities of myasthenia gravis (MG), we present two cases of thymoma-associated MG patients. Alopecia, pure red cell aplasia, and thymoma- associated multiorgan autoimmunity were observed in Case 1, and alopecia, thrombocytopenia, hypogammaglobulinemia and nephrotic syndrome were observed in Case 2. In both cases, autoreactive T lymphocytes inappropriately stimulated by thymus tissue may have played key roles in generating the various autoimmune-associated symptoms. Consequently, systemic immunological involvement due to the thymoma-associated breakdown of immunoregulations in both motor and non-motor systems should be considered in MG patients.

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“…See Table 1 for previously reported cases of MG with or without thymic disease and glomerular disease. 1,8,18,19,22,23,26–39 A newer case report by Bolz et al 40 was added where the MGN could be classified as primary in setting of anti-PLA2R antibody positivity. There are 11 other cases with similar presentation to our currently presented case (total of 12 with current case): nine cases with MG and concomitant MGN and three cases with thymus disease (benign or malignant), MGN, but no active MG. A variety of other nephropathies that present with MG and both benign and malignant thymomas are also listed and totaled 70 cases.…”

Section: Discussionmentioning

confidence: 99%

Secondary membranous nephropathy in a patient with myasthenia gravis without thymic disease, and partial remission induced by adrenocorticotropic hormone therapy

Hanna

Arman

Selamet

et al. 2019

SAGE Open Medical Case Reports

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Membranous glomerulonephritis is the most common glomerular disease in adults. Its primary form has been characterized with formation of phospholipase A2 receptor antibodies. Malignancy, infections, and autoimmune disorders are the most common causes of secondary membranous glomerulonephritis. We present a case of a 55-year-old African American female who presented with nephrotic range proteinuria and diagnosed with secondary membranous glomerulonephritis based on distinct pathological features on kidney biopsy and absence of serum phospholipase A2 receptor antibodies. She initially underwent extensive workup for malignancies, infections, and common autoimmune disorders which were all negative. Her proteinuria remained resistant to steroid treatment and she was treated with subcutaneous adrenocorticotropic hormone injections. Meanwhile, she was also diagnosed with the anti-muscle specific kinase antibody variant of myasthenia gravis. In literature, there are few case reports of myasthenia gravis as a cause of secondary membranous glomerulonephritis. In our case, the lack of other inciting factors also suggested this association.

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Nephrotic syndrome after thymectomy for myasthenia gravis

Cited by 3 publications

References 3 publications

Minimal change disease in a patient with myasthenia gravis

Minimal change disease in a patient with myasthenia gravis

Non-motor Comorbidity of Myasthenia Gravis: Myasthenia Gravis as a Systemic Immunological Disorder Involving Non-motor Systems

Secondary membranous nephropathy in a patient with myasthenia gravis without thymic disease, and partial remission induced by adrenocorticotropic hormone therapy

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