Membranous glomerulonephritis in a patient with an adrenal ganglioneuroma.
Membranous glomerulonephritis has been reported in association with several tumors. This report is the first case of membranous glomerulonephritis associated with an adrenal ganglioneuroma. The sera obtained from the patient at presentation stained the fibrillary component of the ganglioneuroma and the glomerular basement membrane of the kidney. The antibodies present in the patient's serum also reacted with the glomerular basement membrane of several normal and randomly selected abnormal kidneys, including 1 from a patient with Alport's syndrome. The patient's sera contained a circulating tumor antigen-specific antibody that cross-reacted with an antigen present on the podocyte membrane of the renal glomeruli. The resection of the ganglioneuroma resulted in a complete remission of the nephrotic syndrome within months of removal of the tumor. This was associated with loss of antibodies in the patient's serum. The patient was not treated with steroids or any immunosuppressive agents. The patient remains in remission with normal renal function after 9 years of follow-up.
Wadhwa
Nand K
NK
Division of Nephrology, Department of Medicine, State University of New York at Stony Brook, Stony Brook, NY 11794-8152, USA. nwadhwa@notes.cc.sunysb.edu
Gupta
Monika
M
Afolabi
Ainfemi
A
Miller
Frederick
F
D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000276:immunology / Q000601:surgery; D000912:Antibodies, Neoplasm / Q000097:blood; D000951:Antigens, Neoplasm / Q000276:immunology; D000954:Antigens, Surface / Q000276:immunology; D001324:Autoantigens / Q000276:immunology; D004847:Epithelial Cells / Q000276:immunology; D005260:Female; D005729:Ganglioneuroma / Q000150:complications* / Q000175:diagnosis / Q000276:immunology / Q000601:surgery; D015433:Glomerulonephritis, Membranous / Q000209:etiology* / Q000276:immunology; D006801:Humans; D007668:Kidney / Q000276:immunology; D007678:Kidney Glomerulus / Q000276:immunology; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000209:etiology; D012074:Remission Induction
D000912:Antibodies, Neoplasm; D000951:Antigens, Neoplasm; D000954:Antigens, Surface; D001324:Autoantigens