Underlying malignancy has been thought to be responsible for 5–10% of the cases of membranous nephropathy in adults, with the risk being highest in patients over the age of 60 years. Solid tumors such as carcinomas of lung or colon, are most often involved. It is presumed that tumor antigens are deposited in the glomeruli; this is followed by antibody deposition and complement activation, leading to epithelial cell and basement membrane injury and proteinuria due to the associated increase in glomerular permeability. We describe a patient with a resistant nephrotic syndrome and massive proteinuria due to membranous nephropathy associated with pleural mesothelioma.

Keywords:
Mesothelioma, Membranous nephropathy, Nephrotic syndrome
1.
Eagen JW, Lewis EJ: Glomerulonephritis of neoplasia. Kidney Int 1971;11:297–306.
2.
Charles E, Cotran A, Cotran R: Neoplasia and glomerular injury. Kidney Int 1986;30:465–473.
3.
Gagliano RG, Costanzi JJ, Beathard GA, Sarles HE, Ball JD: The nephrotic syndrome associated with neoplasia: An unusual paraneoplastic syndrome. Am J Med 1976;60:1026–1031.
4.
Burstein DM, Korbet SM, Schwartz MM: Membranous glomerulonephritis and malignancy. Am J Kidney Dis 1993;22:5–10.
5.
Barton CH, Vaziri ND, Spear GS: Nephrotic syndrome associated with adenocarcinoma of breast. Am J Med 1980;68:308–312.
6.
Seney FD Jr, Federgreen WR, Stein H, Kashgarin M: A review of nephrotic syndrome associated with chronic lymphocytic leukemia. Arch Intern Med 1986;146:137–141.
7.
Ghosh L, Muemrcke RC: Nephrotic syndrome: A prodrome to lymphoma. Ann Intern Med 1970;72:379–382.
8.
Plager J, Stutzman L: Acute nephrotic syndrome as a manifestation of Hodgkin’s disease: Report of four cases and review of the literature. Am J Med 1971;50:56–66.
9.
Lewis MG, Longridge LW, Phillips TM: Immunological studies in nephrotic syndrome associated with extrarenal malignant disease. Lancet 1971;ii:134–135.
10.
Constanza ME, Pinn V, Schwartz RS, Nathanson L: Carcinoembryonic antigen-antibody complexes in a patient with colonic carcinoma and nephrotic syndrome. N Engl J Med 1973;289:520–522.
11.
Venzano C, Di Marco E, Garbero M, Forno P, Marchese A, Borghesi R: Nephrotic syndrome associated with pleural mesothelioma: An unusual paraneoplastic event. Recenti Prog Med 1990;81:325–326.
12.
Beaufils H, Jouanneau C, Chomette G: Kidney and cancer: Results of immunofluorescence microscopy. Nephron 1985;40:303–308.
13.
Keur I, Krediet RT, Arisz L: Glomerulopathy as a paraneoplastic phenomenon. Neth J Med 1989;34:270–284.
14.
Couser WG, Wagenfeld JB, Spargo BH, Lewsi EJ: Glomerular deposition of tumor antigen in membranous nephropathy associated with colonic carcinoma. Am J Med 1974;57:962–970.
15.
Bruggemeyer CD, Ramirez G: Membranous nephropathy: A concern for malignancy. Am J Kidney Dis 1987;9:23–26.
16.
Weksler M, Carey T, Day N, Susin M, Sherman R, Backer C: Nephrotic syndrome in malignant melanoma: Demonstration of melanoma antigen-antibody in the kidney (abstract). Kidney Int 1974;6:112.
17.
Pascal RR, Slovin SF: Tumor-directed antibody and carcinoembryonic antigen in the glomeruli of a patient with gastric carcinoma. Hum Pathol 1980;11:679–682.
18.
Hyman LR, Burkholder PM, Joo PA, Segar WE: Malignant lymphoma and nephrotic syndrome: A clinicopathologic analysis with light, immunofluorescence and electron microscopy of the renal lesion. J Pediatr 1973;82:207–217.
© 1999 S. Karger AG, Basel
2000
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