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Membranous Nephropathy Secondary to Graves' Disease: A Case Report.
Neves, Precil Diego Miranda de Menezes; Muniz, Monique Pereira Rêgo; Morgantetti, Giuliano Ferreira; Cutrim, Érico Murilo Monteiro; Macieira, Carlos de Andrade; Salgado-Filho, Natalino; Lages, Joyce Santos; Brito, Dyego José de Araújo; Cunha, Kaile de Araújo; Gatto, Giuseppe Cesare; Silva, Gyl Eanes Barros.
Afiliação
  • Neves PDMM; Nephrology Division, University of São Paulo School of Medicine, São Paulo, Brazil.
  • Muniz MPR; Nephrology and Dialysis Center, Oswaldo Cruz German Hospital, São Paulo, Brazil.
  • Morgantetti GF; Department of Nephrology, Federal University of Maranhão, São Luís, Brazil.
  • Cutrim ÉMM; Pathology Division, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
  • Macieira CA; University Hospital of Federal University of Maranhão, São Luís, Brazil.
  • Salgado-Filho N; Department of Nephrology, Federal University of Maranhão, São Luís, Brazil.
  • Lages JS; Department of Nephrology, Federal University of Maranhão, São Luís, Brazil.
  • Brito DJA; University Hospital of Federal University of Maranhão, São Luís, Brazil.
  • Cunha KA; Department of Nephrology, Federal University of Maranhão, São Luís, Brazil.
  • Gatto GC; University Hospital of Federal University of Maranhão, São Luís, Brazil.
  • Silva GEB; Nephrology Service, University Hospital, University of Brasília, Brasília, Brazil.
Front Immunol ; 13: 824124, 2022.
Article em En | MEDLINE | ID: mdl-35734176
Membranous nephropathy (MN) is a form of kidney disease that is idiopathic in 70%-80% of cases. Glomerular involvement in autoimmune thyroiditis can occur in 10%-30% of patients, and MN manifests in association with Hashimoto thyroiditis in up to 20% of the cases with glomerular involvement. Reports of MN associated with Graves' disease (GD) are extremely rare in the current literature. Herein, we report the case of a 46-year-old man admitted to the hospital with nephrotic syndrome and symptomatic hyperthyroidism due to GD. Kidney biopsy revealed a secondary MN pattern. Immunohistochemical staining for PLA2R was negative, and thyroglobulin showed weak and segmental staining along the glomerular capillary. Anti-thyroid peroxidase (TPO) antibody test was not performed. The patient was treated for GD with methimazole and prednisone, and despite reaching clinical improvement after 8 months, proteinuria remained close to nephrotic levels. In this scenario, the patient was submitted to radioactive iodine, and there was a dramatic reduction in proteinuria levels after treatment. In conclusion, GD association with MN is rare, and when present, diagnosis using PLA2R and immunohistochemistry can be useful in determining association. In addition, radioactive iodine therapy can be an effective treatment modality when preceded with immunosuppressive corticosteroid therapy.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Glândula Tireoide / Glomerulonefrite Membranosa / Doença de Graves Tipo de estudo: Diagnostic_studies / Etiology_studies Limite: Humans / Male / Middle aged Idioma: En Revista: Front Immunol Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Suíça
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Glândula Tireoide / Glomerulonefrite Membranosa / Doença de Graves Tipo de estudo: Diagnostic_studies / Etiology_studies Limite: Humans / Male / Middle aged Idioma: En Revista: Front Immunol Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Suíça