Abstract
Several cases of glomerulonephritis have been associated with autoimmune thyroid diseases. Most frequent renal lesion described was membranous glomerulonephritis presenting with nephrotic syndrome. This is a case history of a 58-year-old male presenting with nephrotic syndrome secondary to membranoproliferative glomerulonephritis and associated autoimmune thyroiditis. Hisserum complement levels were decreased with high titres of circulating antithyroid peroxidase antibodies and thyrotropin receptor antibodies. Renal biopsy showed membranoproliferative glomerulonephritis with the finding of increased tuft cellularity, lobular accentuation,neutrophilinfiltratedglomeruli and thickened basement membrane. Antithyroid drugs along with steroids led to significant reduction in proteinuria and resolution of oedema.
Highlights
Autoimmune thyroiditis and many primary glomerular diseases arise from the abnormalities of immunoregulation
It has been reported that autoimmune thyroiditis is associated with mixed pathological morphology marked by predominant membranous glomerulopathy
Thyroid disease may be linked to different forms of glomerulonephritis
Summary
Autoimmune thyroiditis and many primary glomerular diseases arise from the abnormalities of immunoregulation. Over a period of one year, he had loss of weight of 8kg, increased appetite, sweating and palpitations which had not been investigated He denied any painful neck swelling or eye symptoms. On physical examination he had a body mass index of 18.8 Kg/m2, a regular heart rate of 120bpm and blood pressure of 170/100mmHg, bilateral pleural effusions and bilateral ankle oedema. Erythrocyte sedimentation rate, C-reactive protein, serum electrolytes and serum creatinine were within the normal range. His urine analysis showed microscopic haematuria (fieldfull red cells and 20-30 pus cells per high power field) with heavy proteinuria. Hepatitis B & C, rheumatoid factor, antinuclear antibody, double stranded DNA, anti neutrophil cytoplasmic antibody were negative, low C3 (38mg/dl) with normal C4 were seen. anti-thyroid peroxidase antibodies (anti-TPO antibodies) were strongly positive >140U/ml (
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