Clinicopathological study of membranous glomerulonephritis in patients with rheumatoid arthritis

• Published in: Nihon Jinzo Gakkai shi Vol. 34; no. 3; pp. 301 - 307
• Main Authors: SHIMOKAMA, TATSURO, BABA, NAOKI, SIIOUNO, YOSIIIYUKI, WATANABE, TERUO, SAKEMI, TAKANOBU, HARADA, ATSUMI
• Format: Journal Article
• Language: Japanese
• Published: Japan Japanese Society of Nephrology 01-03-1992
• Subjects: Adult; Aged; Arthritis, Rheumatoid - complications; Female; Glomerulonephritis, Membranous - etiology; Glomerulonephritis, Membranous - pathology; Humans; Kidney Glomerulus - ultrastructure; Male; membranous glomerulonephritis, rheumatoid arthritis, chrysotherapy; Middle Aged
• ISSN: 0385-2385; 1884-0728
• DOI: 10.14842/jpnjnephrol1959.34.301

Of 103 patients with membranous glomerulonephritis proved by renal biopsy. 11 (10.7%) had rheumatoid arthritis. Nine of these 11 patients received systemic treatment with anti-rheumatic remedies including gold, D-penicillamine and bucillamine. Two others were administered only token of nonsteroidal antiinflammatory drugs. Renal function of the patients was well maintained and within normal limtis. Four patients showed nephrotic syndrome, while mild to moderate proteinuria was found in the other 7. Hema turia was minimal to mild, and it was not a major symptom. Six patients resolved proteinnuria completely and 2 patients incompletely after discontinuation of chrysotherapy. Nine cases of the membranous lesion in patients with rheumatoid arthritis were stage 1.Thus it was often difficult to identify the glomerular change only by light microscopy. IgA nephropathy and AA amyloidosis were associated in one patient respectively. Our data lead us to conclude that chrysotherapy would cause membranous lesions, but rheu matoid arthritis itself also induce membranous glomerulonephritis.