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Minimal-Change Nephropathy Associated With Pancreatic Carcinoma

Minimal-Change Nephropathy Associated With Pancreatic Carcinoma Abstract • A 67-year-old man presented with nephrotic syndrome and polymyalgia rheumatica. A renal biopsy revealed minimal-change nephropathy. The proteinuria and rheumatologic findings responded to prednisone therapy. The patient presented three months later with biliary tract obstruction secondary to pancreatic adenocarcinoma metastatic to the liver. The glomerulopathy and polymyalgia rheumatica in this case seemed to be components of the paraneoplastic syndrome. The response of both entities to prednisone therapy supports the hypothesis that they are caused by derangements in cell-mediated immunity. The fact that the tumor progressed despite resolution of the nephrosis and polymyalgia rheumatica suggests that cell-mediated immunity in general is altered by the tumor and not that the carcinoma liberates a factor that directly damages the kidney. (Arch Intern Med 1988;148:975-976) References 1. Hoyer JR: Idiopathic nephrotic syndrome with minimal glomerular changes. Contemp Issues Nephrol 1982;9:145-174. 2. Schroeter NJ, Rushing DA, Parker JP, et al: Minimal-change nephrotic syndrome associated with malignant mesothelioma. Arch Intern Med 1986;146:1834-1836.Crossref 3. Eagen JW, Lewis EJ: Glomerulopathies of neoplasia. Kidney Int 1977;11:297-306.Crossref 4. Shalhoub RJ: Pathogenesis of lipoid nephrosis: A disorder of T cell function. Lancet 1974;2:556-564.Crossref 5. Mallick NP: The pathogenesis of minimal change nephropathy. Clin Nephrol 1977;7:87-91. 6. Wu MJ, Moorthy AV: Suppressor cell function in patients with primary glomerular disease. Clin Immunol Immunopathol 1982;22:442-447.Crossref 7. Averbuch SD, Austin HA, Sherwin SA, et al: Acute interstitial nephritis with the nephrotic syndrome following recombinant leukocyte A interferon therapy for mycosis fungoides. N Engl J Med 1984;310:32-35.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Minimal-Change Nephropathy Associated With Pancreatic Carcinoma

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Publisher
American Medical Association
Copyright
Copyright © 1988 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1988.00380040215030
Publisher site
See Article on Publisher Site

Abstract

Abstract • A 67-year-old man presented with nephrotic syndrome and polymyalgia rheumatica. A renal biopsy revealed minimal-change nephropathy. The proteinuria and rheumatologic findings responded to prednisone therapy. The patient presented three months later with biliary tract obstruction secondary to pancreatic adenocarcinoma metastatic to the liver. The glomerulopathy and polymyalgia rheumatica in this case seemed to be components of the paraneoplastic syndrome. The response of both entities to prednisone therapy supports the hypothesis that they are caused by derangements in cell-mediated immunity. The fact that the tumor progressed despite resolution of the nephrosis and polymyalgia rheumatica suggests that cell-mediated immunity in general is altered by the tumor and not that the carcinoma liberates a factor that directly damages the kidney. (Arch Intern Med 1988;148:975-976) References 1. Hoyer JR: Idiopathic nephrotic syndrome with minimal glomerular changes. Contemp Issues Nephrol 1982;9:145-174. 2. Schroeter NJ, Rushing DA, Parker JP, et al: Minimal-change nephrotic syndrome associated with malignant mesothelioma. Arch Intern Med 1986;146:1834-1836.Crossref 3. Eagen JW, Lewis EJ: Glomerulopathies of neoplasia. Kidney Int 1977;11:297-306.Crossref 4. Shalhoub RJ: Pathogenesis of lipoid nephrosis: A disorder of T cell function. Lancet 1974;2:556-564.Crossref 5. Mallick NP: The pathogenesis of minimal change nephropathy. Clin Nephrol 1977;7:87-91. 6. Wu MJ, Moorthy AV: Suppressor cell function in patients with primary glomerular disease. Clin Immunol Immunopathol 1982;22:442-447.Crossref 7. Averbuch SD, Austin HA, Sherwin SA, et al: Acute interstitial nephritis with the nephrotic syndrome following recombinant leukocyte A interferon therapy for mycosis fungoides. N Engl J Med 1984;310:32-35.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Apr 1, 1988

References

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