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Yu CY, Liu J, Qi CH, Wu ZY, Xiao YF, Zhang XG. Minimal change disease associated with gastrointestinal stromal tumor accompanied by significantly elevated serum IgE level: a case report. BMC Nephrol 2022; 23:139. [PMID: 35410141 PMCID: PMC8996523 DOI: 10.1186/s12882-022-02775-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 04/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Minimal change disease (MCD) is a common cause of the nephrotic syndrome. Several studies have shown an increased incidence of cancer in patients with MCD. However, there are no reports on the association between MCD and gastrointestinal stromal tumor (GIST). CASE PRESENTATION We report a case of a 66-year-old female with severe nephrotic syndrome and concomitant duodenal GIST. Immunoglobulin test showed a significant increase of IgE levels. The diagnosis of renal histopathology was MCD with subacute tubulointerstitial injury. The combination of preoperative Imatinib mesylate chemotherapy and tumor excision was accompanied by significant remission of proteinuria, and IgE level decreasing, without immunosuppressivetherapy. CONCLUSIONS It is the first case report that MCD was associated with GIST and elevated IgE level. Clinically, in patients with elevated IgE level associated with nephrotic syndrome, the possibility of tumor must be taken into account when allergic factors are excluded.
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Affiliation(s)
- Chun-Yang Yu
- Department of Nephrology, Aerospace Center Hospital, Beijing, 100049, China
| | - Jie Liu
- Health Management Center, Aerospace General Hospital, Beijing, China
| | - Chang-Hai Qi
- Department of Pathology, Aerospace Center Hospital, Beijing, China
| | - Zhen-Yu Wu
- Department of Hepatological Surgery, Aerospace Center Hospital, Beijing, China
| | - Yue-Fei Xiao
- Department of Nephrology, Aerospace Center Hospital, Beijing, 100049, China.
| | - Xue-Guang Zhang
- Department of Nephrology, Capital Medical University Electric Teaching Hospital (State Grid Corporation of China Beijing Electric Power Hospital), Beijing, China.
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Hanna RM, Arman F, Selamet U, Wallace WD, Barsoum M, Rastogi A, Nobakht N, Shieh P. Secondary membranous nephropathy in a patient with myasthenia gravis without thymic disease, and partial remission induced by adrenocorticotropic hormone therapy. SAGE Open Med Case Rep 2019; 7:2050313X19869764. [PMID: 31448123 PMCID: PMC6689923 DOI: 10.1177/2050313x19869764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 07/23/2019] [Indexed: 11/27/2022] Open
Abstract
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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Affiliation(s)
- Ramy M Hanna
- Division of Nephrology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.,Division of Nephrology, Department of Medicine, School of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Farid Arman
- Division of Nephrology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Umut Selamet
- Division of Nephrology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - William D Wallace
- Department of Pathology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Marina Barsoum
- Division of Nephrology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Anjay Rastogi
- Division of Nephrology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Niloofar Nobakht
- Division of Nephrology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Perry Shieh
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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Ozaki K, Ohkubo T, Yamada T, Yoshioka K, Ichijo M, Majima T, Kudo S, Akashi T, Honda K, Ito E, Watanabe M, Sekine M, Hamagaki M, Eishi Y, Sanjo N, Ishibashi S, Mizusawa H, Yokota T. Progressive Encephalomyelitis with Rigidity and Myoclonus Resolving after Thymectomy with Subsequent Anasarca: An Autopsy Case. Intern Med 2018; 57:3451-3458. [PMID: 29984771 PMCID: PMC6306531 DOI: 10.2169/internalmedicine.1238-18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Progressive encephalomyelitis with rigidity and myoclonus (PERM) is an autoimmune disorder involving the brainstem and spinal cord and is sometimes associated with thymoma. We encountered a 75-year-old woman with typical PERM features, glycine receptor antibody, and thymoma. Her neurologic symptoms improved after thymectomy, but she unexpectedly developed anasarca with massive pleural effusions and hypoalbuminemia and finally succumbed to death. The autopsy showed edema and mononuclear infiltration in the pleura but no neuropathological findings typical of PERM. Effective treatment of PERM can reverse the neuropathological signs of encephalomyelitis. The autoimmune nature of anasarca is possible but not proven.
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Affiliation(s)
- Kokoro Ozaki
- Department of Neurology and Neurological Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Takuya Ohkubo
- Department of Neurology and Neurological Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Tetsuo Yamada
- Department of Clinical Laboratory Medicine, Graduate School of Health Care Science, Bunkyo Gakuin University, Japan
| | - Kotaro Yoshioka
- Department of Neurology and Neurological Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Masahiko Ichijo
- Department of Neurology and Neurological Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Takamasa Majima
- Department of Neurology and Neurological Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Shunsuke Kudo
- Department of Neurology and Neurological Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Takumi Akashi
- Department of Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Keiji Honda
- Department of Otolaryngology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Eisaku Ito
- Department of Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Mayumi Watanabe
- Department of Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Masaki Sekine
- Department of Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Miwako Hamagaki
- Department of Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Yoshinobu Eishi
- Department of Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Nobuo Sanjo
- Department of Neurology and Neurological Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Satoru Ishibashi
- Department of Neurology and Neurological Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Hidehiro Mizusawa
- Department of Neurology and Neurological Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
- The National Center Hospital, National Center of Neurology and Psychiatry, Japan
| | - Takanori Yokota
- Department of Neurology and Neurological Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
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Calviño J, Adeva M, Sobrido MJ. Membranous nephropathy, leiomyoma and autoimmune myasthenia: more than a coincidence? Clin Kidney J 2012; 5:562-5. [PMID: 26069802 PMCID: PMC4400566 DOI: 10.1093/ckj/sfs144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 09/12/2012] [Indexed: 11/14/2022] Open
Abstract
Membranous nephropathy (MN) has been associated with several infectious, immunological and malignant conditions, but had only rarely been reported with malignant and other immune disorders in the same patient. We describe the case of a 56-year-old male with MN who was also diagnosed with a gastrointestinal stromal tumour (GIST), myasthenia gravis (MG) and thymic hyperplasia. Thus, we report here for the first time the coincidence of these conditions in the same patient. There was a recurrence of nephrotic syndrome without impairment of renal function 5 years after removal of the GIST (3 years after thymectomy). The possible basis for the relationship between these diseases is discussed, and some common genetic and immune physiopathological pathways are hypothesized.
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Affiliation(s)
- Jesus Calviño
- Department of Nephrology , Hospital Lucus Augusti , Lugo , Spain
| | - Magdalena Adeva
- Department of Nephrology , Hospital Juan Cardona , Ferrol , Spain
| | - Maria-Jesus Sobrido
- Department of Neurogenetics , Fundación Publica Galega de Medicina Xenómica-SERGAS and Centre for Network Research on Rare Diseases (CIBERER), Institute of Health Carlos III , Santiago Compostela , Spain
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