Clinicopathological analysis of 12 cases of thymoma-associated glomerulonephropathy

Abstract

Objective To elucidate the clinical and pathological characteristics of the patients with thymoma-associated glomerulonephropathy. Methods In this retrospective study, the clinicopathologic characteristics of patients diagnosed as thymoma-associated glomerulonephropathy in Peking University First Hospital during the period between Oct 2008 and Jun 2017 were analyzed, including the histological classfication of thymoma, the clinicopathological features and the short-term prognosis. Results Altogether twelve patients were included with an average age of (55±16) years; male/female ratio was 3∶1. The B2 type thymoma was the most common type. Nine cases also suffered from myasthenia gravis, and eight cases of glomerulopathy accompanied by thymoma activity. The clinical presentation of glomerulopathy included nephrotic syndrome (11/12), acute kidney injury (10/12). Eleven patients received renal biopsy, among which five cases were minimal change nephropathy, three cases were membranous nephropathy, and the other three cases were focal segmental glomerulosclerosis, thrombotic microangiopathy and endocapillary proliferative glomerulonephritis, respectively. Eleven patients received immunosuppression therapy. After a median 12 months follow up, the proteinuria decreased in 7 cases, and renal function completely or partially recovered in 6 cases. Conclusions Minimal change disease is the most frequent pathological type of thymoma-associated glomerulonephropathy. Immunotherapy with glucocorticoid as first-line drug may be considered for thymoma-associated glomerulonephropathy with surgery, chemoradiation contraindications or non-remission of kidney disease after anti-tumor therapy. Key words: Thymoma; Kidney diseases; Paraneoplastic syndrome