title: Thyroid antigen-antibody nephritis: possible involvement of fucosyl-GM1 as the antigen.
abstract: Hyperthyroidism, microscopic hematuria, and proteinuria developed in an 11-year-old girl. Proteinuria decreased during treatment of hyperthyroidism with an antithyroid drug. On admission, serum anti-thyroglobulin antibody, antimicrosomal antibody, and immune complex were present. The thyrotropin binding inhibitory immunoglobulin (TBII) level was low. On the other hand, an antibody to the ganglioside component (fucosyl-GM1) was detected by an enzyme linked immunosolvent assay (ELISA). A thyroid biopsy specimen showed massive lymphocytic infiltration and interstitial fibrosis. A renal biopsy specimen showed marked proliferation of mesangial cells and increased mesangial matrix with focal segmental capillary wall abnormality. Electron microscopec studies demonstrated mild paramesangial dense deposits. By indirect immunofluorescence, granular glomerular basement membrane and mesangial staining were not detected with rabbit antibody to thyroglobulin, but were detected with rabbit antibody to fucosyl GM1. Fucosyl GM1 was also seen along the basilar aspect of the thyroid follicular epithelial cells. These observation suggests the development of glomerulonephritis mediated by thyroid antigen, particularly ganglioside component.
authors.affiliation: Department of Pediatrics, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Matsuura
authors.forename: Y
authors.initials: Y
authors.lastname: Kikkawa
authors.forename: K
authors.initials: K
authors.lastname: Akashi
authors.forename: T
authors.initials: T
authors.lastname: Kitagawa
authors.forename: Z
authors.initials: Z
authors.lastname: Inage
authors.forename: M
authors.initials: M
authors.lastname: Iwamori
authors.forename: T
authors.initials: T
authors.lastname: Takimoto
authors.forename: K
authors.initials: K
authors.lastname: Iidaka
authors.forename: T
authors.initials: T
authors.lastname: Serisawa
mesh_terms: D000936:Antigen-Antibody Complex / Q000032:analysis / Q000276:immunology*; D002648:Child; D005260:Female; D005455:Fluorescent Antibody Technique; D005677:G(M1) Ganglioside / Q000031:analogs & derivatives* / Q000032:analysis / Q000276:immunology; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications / Q000276:immunology* / Q000473:pathology; D009393:Nephritis / Q000209:etiology / Q000276:immunology* / Q000473:pathology
chemical_list: D000936:Antigen-Antibody Complex; D005677:G(M1) Ganglioside; C039123:fucosyl GM1 ganglioside