Proteinuria in a patient with Graves’ disease

Pediatric Nephrology

August 2019, Volume 34, Issue 8, pp 1383–1385| Cite as

Proteinuria in a patient with Graves’ disease: Answers

• Authors
• Authors and affiliations

• 

• Aydilek Dagdeviren Cakir
  • 1
  Email author
• Nur Canpolat
  • 2
• Seha Saygili
  • 2
• Isin Kilicaslan
  • 3
• Hande Turan
  • 1
• Oya Ercan
  • 1
• Olcay Evliyaoglu
  • 1

1. 1.Department of Pediatric Endocrinology, Cerrahpasa Faculty of MedicineIstanbul University-CerrahpasaFatih, IstanbulTurkey
2. 2.Department of Pediatric Nephrology, Cerrahpasa Faculty of MedicineIstanbul University-CerrahpasaIstanbulTurkey
3. 3.Department of Pathology, Istanbul Faculty of MedicineIstanbul UniversityIstanbulTurkey

Answers

1. 1.
   Histopathologic examination of the renal biopsy was consistent with membranous nephropathy (MN) which was characterized by diffuse thickening of the glomerular basement membrane (GBM) by light microscopy and a diffuse granular deposition of IgG and C3 along the GBM on immunofluorescence.
    
2. 2.
   In childhood, secondary membranous nephropathies are significantly more common, associated with systemic autoimmune diseases, infections, drugs, and malignancies, whereas primary MN is uncommon [1, 2, 3]. The distinction between primary and secondary forms of MN is of great importance for the diagnosis and clinical management. Antibodies to M type phospholipase A2 receptors (PLA2R) is valuable for diagnosing primary MN with a high rate of sensitivity (> 75%) and specificity (100%) [4, 5]. PLA2R staining on renal biopsies is reported as 45–100% in children and adolescents with MN [6, 7]. Our patient had serum anti-PLA2R antibody (1:320 IG G titers) and diagnosed as primary MN. We were...

Keywords

Anti-PLA2R Children Graves’ disease Membranous nephropathy Rituximab