1 research outputs found
Glomerular Diseases Associated with Malignancies: Histopathological Pattern and Association with Circulating Autoantibodies
Aim: Glomerular diseases (GD) associated with malignancies (AM, GDAM)
have unique features, which are important to recognize, in the light of
the progress made in cancer therapy. We aimed to describe the clinical
and histopathological characteristics of patients with GDAM in relation
to the presence of circulating autoantibodies, pointing to potential
immune pathogenic pathways connecting cancer to GD. Materials and
Methods: The included patients were studied retrospectively on the basis
of a kidney biopsy proving GD and a related biopsy to establish the
diagnosis of AM. We recorded patients’ demographics, serological and
laboratory parameters, histopathological findings, and the type of
malignancy, GD, and therapy. Results: In total, 41 patients with GDAM,
with a mean age of 63.1 (+/- 10.7) years, were studied. In 28 (68.3%)
cases, GD was associated with a solid tumor, and in 13 (31.7%) patients
with a lymphoid malignancy. The most frequent histopathological pattern
was membranous nephropathy (43.9%). Overall, at the time of GD
diagnosis, 17% of the patients were positive for antinuclear antibodies
(ANA), and 12.2% for antineutrophil cytoplasmic autoantibodies (ANCA),
all against myeloperoxidase (MPO). In addition, 93.3% of the patients
who had membranous nephropathy were negative for transmembrane
glycoprotein M-type phospholipase A(2)receptor (PLA(2)R) antibody.
Sixteen patients (39.0%) presented with acute nephritic syndrome, of
whom five (31.25%) developed rapidly progressive glomerulonephritis. In
a mean follow-up time of 36.1 (+/- 28.3) months, nine (21.95%) patients
ended up with end-stage kidney disease, and eight (19.5%) died.
Conclusion: We found that 3.2% of patients who underwent a native
kidney biopsy in our institution during the past decade, for any reason,
were identified as having some type of GD associated with a malignancy.
Serology indicated a significant presence of ANA or MPO-ANCA antibodies
in patients with nephritic syndrome and the absence of PLA(2)R
antibodies in patients with membranous nephropathy