A case of severe nephrotic syndrome (urinary protein excretion 12.9 g/day) due to membranous nephropathy associated with untreated prostate cancer and multiple bone metastases is described. A combination of initial endocrine treatment and steroid therapy resulted in normalization of prostate-specific antigen levels followed by a rapid decrease of urinary protein excretion within 4 months. No proteinuria was subsequently detected. Seven months after the initiation of therapy, the patient remained well with complete clinical remission from the nephrotic syndrome. This rapid achievement of remission may have been due to tumor shrinkage by androgen ablation in addition to steroid therapy of the membranous nephropathy. The nephrotic syndrome is a rare complication of prostate cancer, and, to the best of our knowledge, no previous cases have been reported of membranous nephropathy as one of the first disease manifestations.

Keywords:
Nephrotic syndrome, Membranous nephropathy, Prostate cancer
1.
Couser WG, Abrass CK: Pathogenesis of membranous nephropathy. Annu Rev Med 1988;39:517–530.
2.
Austin HAD, Antonovych TT, MacKay K, Boumpas DT, Balow JE: NIH Conference. Membranous nephropathy. Ann Intern Med 1992;116:672–682.
3.
Brueggemeyer CD, Ramirez G: Membranous nephropathy: A concern for malignancy. Am J Kidney Dis 1987;9:23–26.
4.
Burstein DM, Korbet SM, Schwartz MM: Membranous glomerulonephritis and malignancy. J R Coll Physicians Lond 1993;27:247–251.
5.
Yamauchi H, Linsey MS, Biava CG, Hopper J Jr: Cure of membranous nephropathy after resection of carcinoma. Arch Intern Med 1985;145:2061–2063.
6.
Fer MF, McKinney TD, Richardson RL, Hande KR, Oldham RK, Greco FA: Cancer and the kidney: Complications of neoplasms. Am J Med 1981;71:704–718.
7.
Eagen JW: Glomerulopathies of neoplasia. Kidney Int 1977;11:297–303.
8.
Alpers CE, Cotran RS: Neoplasia and glomerular injury. Kidney Int 1986;30:465–473.
9.
Couser WG: Pathogenesis of glomerulonephritis. Kidney Int 1993;42(suppl):19–26.
10.
Couser WG: Pathogenesis of glomerular damage in glomerulonephritis. Nephrol Dial Transplant 1998;13(suppl 1):10–15.
11.
Rapoport J, Kuperman O, Gopas Y, Maor E, Eyal A, Mostovslavski M, et al: Nephrotic syndrome associated with transitional cell carcinoma of the bladder. Nephron 1989;52:36–39.
12.
Hotta O, Taguma Y, Kurosawa K, Sudo K, Takahashi H: Membranous nephropathy associated with nodular sclerosing Hodgkin’s disease. Nephron 1993;63:347–350.
13.
Pei Y, Cattran D, Greenwood C: Predicting chronic renal insufficiency in idiopathic membranous glomerulonephritis. J Pathol 1992;168:221–227.
14.
Cattran DC, Delmore T, Roscoe J, Cole E, Cardella C, Charron R, Ritchie S: A randomized controlled trial of prednisone in patients with idiopathic membranous nephropathy. N Engl J Med 1989;320:210–215.
15.
Mallick NP, Short CD, Manos J: Clinical membranous nephropathy. Nephron 1983;34:209–219.
16.
Cameron JS, Healy MJ, Adu D: The Medical Research Council trial of short-term high-dose alternate day prednisolone in idiopathic membranous nephropathy with nephrotic syndrome in adults. The MRC Glomerulonephritis Working Party. Q J Med 1990;74:133–156.
17.
Denis J, Mignon F, Ramee MP, Morel-Maroger L, Richet G: Extramembranous glomerulitis associated with visceral tumours: Clinical and histological study based upon 10 cases and a review of the literature (in French). Nouv Presse Méd 1978;7:991–996.
18.
Stuart K, Fallon BG, Cardi MA: Development of the nephrotic syndrome in a patient with prostatic carcinoma. Am J Med 1986;80:295–298.
© 2000 S. Karger AG, Basel
2000
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.