Abstract: TH-PO976
Case Report of Membranous Glomerulonephritis Secondary to Papillary Thyroid Carcinoma
Session Information
- Glomerular Trainee Case Reports
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Trainee Case Report
- 1204 Podocyte Biology
Authors
- Elharrif, Khalid M., University of Texas Medical Branch , Galveston, Texas, United States
- Abifaraj, Farah, University of Texas Medical Branch , Galveston, Texas, United States
- Afrouzian, Marjan, University of Texas Medical Branch , Galveston, Texas, United States
- Kassem, Hania, University of Texas Medical Branch , Galveston, Texas, United States
Introduction
Secondary Membranous glomerulonephritis(GN) is most commonly seen in the setting of autoimmune disease, infection, neoplasia, and with certain therapeutic agents. Malignancies associated with secondary membranous GN are solid tumors such as carcinomas of the prostate, lung, breast, bladder, or gastrointestinal tract, and less frequently hematologic malignancies, such as chronic lymphocytic leukemia. We report a rare case of secondary membranous GN secondary to papillary thyroid carcinoma(PTC). We are not aware of any previous reports of a similar association.
Case Description
A 35-year-old female without significant past medical history, presented with nephrotic range proteinuria (10.6 g of proteinuria in 24 hours) and other features of nephrotic syndrome. Kidney biopsy diagnosis was consistent with secondary MGN with mesangial deposits and variegated deposits in terms of size and distribution. Anti PLA2R antibody serology and immunohistochemical staining were negative. Further work up for secondary MGN, including ANA and viral hepatitis, was negative. Patient underwent age-appropriate cancer screening and was eventually found to have a thyroid nodule with biopsy-proven diagnosis of PTC. The patient underwent thyroidectomy. One month post surgery, her proteinuria significantly improved (down to 4.5 g of proteinuria in 24 hours) with subsequent improvment of her volume status.
Discussion
Secondary Membranous nephropathy is associated with malignant conditions such as solid tumors and less commonly hematological malignancy. We present a unique case of MGN, secondary to PTC, with dramatic improvement of proteinuria post thyroidectomy. This case emphasizes the importance of clinical workup after a diagnosis of secondary MGN, which in our patient, led to the discovery of an unexpected PTC and its successful treatment.