Thyroid antigen associated immune complex glomerulonephritis in Graves' disease.
A 60 year old hyperthyroid black woman with long-standing Graves' disease treated with methimazole presented with anasarca and congestive heart failure. She was found to have the nephrotic syndrome with a urinary protein excretion of 32 g/day. Light and electron microscopy revealed a stage II membranous glomerulopathy. Direct and indirect immunofluorescence demonstrated immunoglobulin G (IgG), immunoglobulin M (IgM), third component of complement and thyroglobulin in a granular diffuse pattern consistent with an immune complex glomerulonephritis. Total thyroidectomy led to a decrease in proteinuria with little change in glomerular filtration rate during an 11 month follow-up period. We believe this to be the first report of immune complex glomerulonephritis associated with thyroid antigen in Graves' disease.
D000936:Antigen-Antibody Complex; D000941:Antigens / Q000032:analysis; D003176:Complement C3 / Q000032:analysis; D005260:Female; D005921:Glomerulonephritis / Q000150:complications* / Q000276:immunology / Q000473:pathology; D006111:Graves Disease / Q000150:complications*; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D007678:Kidney Glomerulus / Q000276:immunology* / Q000473:pathology; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000209:etiology; D013954:Thyroglobulin / Q000276:immunology
D000936:Antigen-Antibody Complex; D000941:Antigens; D003176:Complement C3; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D013954:Thyroglobulin