[Membranoproliferative glomerulonephritis associated with autoimmune thyroiditis]

Nefrologia. 2004:24 Suppl 3:43-8.
[Article in Spanish]

Abstract

Several cases of glomerular disease have been associated to thyroid diseases. The most frequent lesion described is membranous glomerulopathy, presented as a nephrotic syndrome. Here we report a 67-year-old man who developed a nephrotic syndrome accompanied by rapid derangement of renal function shortly after the onset of a primary hypothyroidism due to autoimmune thyroiditis. High titers of circulating anti-thyroglobulin and anti-microsomal thyroid antigen antibodies were detected. Serum levels of C3 and C4 fractions of complement were markedly decreased. Renal biopsy showed a membranoproliferative glomerulonephritis with severe mesangial proliferation, a type of glomerular involvement non-described previously in the literature, in relation with thyroid diseases. Four boluses of intravenous steroids were administered, followed by oral prednisone for three months. A dramatic recovery of renal function, together with normalization of urinary sediment, proteinuria decrease and normalization of serum complement were observed. Three years later, the patient suffered from a similar event, with a positive response to steroids again. One year later, the patient had a new recurrence and was treated with mycophenolate mofetil , improving his clinical situation.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged
  • Autoantibodies / blood
  • Autoimmune Diseases / blood
  • Autoimmune Diseases / complications*
  • Autoimmune Diseases / drug therapy
  • Complement C3 / analysis
  • Complement C3 / deficiency
  • Complement C4 / analysis
  • Complement C4 / deficiency
  • Glomerular Mesangium / pathology
  • Glomerulonephritis, Membranoproliferative / blood
  • Glomerulonephritis, Membranoproliferative / etiology*
  • Glomerulonephritis, Membranoproliferative / pathology
  • Humans
  • Immunoglobulins, Thyroid-Stimulating
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Nephrotic Syndrome / blood
  • Nephrotic Syndrome / etiology*
  • Nephrotic Syndrome / pathology
  • Prednisone / therapeutic use
  • Receptors, Thyrotropin / blood
  • Recurrence
  • Thyroiditis, Autoimmune / blood
  • Thyroiditis, Autoimmune / complications*
  • Thyroiditis, Autoimmune / drug therapy
  • Thyroxine / therapeutic use

Substances

  • Autoantibodies
  • Complement C3
  • Complement C4
  • Immunoglobulins, Thyroid-Stimulating
  • Immunosuppressive Agents
  • Receptors, Thyrotropin
  • thyroid microsomal antibodies
  • thyrotropin-binding inhibitory immunoglobulin
  • Thyroxine
  • Prednisone