Document Detail


Mercury-induced membranous nephropathy: clinical and pathological features.
MedLine Citation:
PMID:  20089494     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Long-term contact with mercury may induce membranous nephropathy (MN); however, the clinical pathologic features and pathogenesis of mercury-induced MN have not been investigated.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The present study retrospectively evaluated 11 cases of mercury-induced MN to analyze its causes and its clinical and pathologic features.
RESULTS: A total of 10 women and 1 man ages 15 to 45 years were enrolled in the present study. Mercury exposure was caused by mercury-containing pills (five patients), skin lightening cream (four patients), hair-dyeing agents (one patient), and mercury vapor (one patient). The duration of contact with mercury ranged from 2 to 60 months, and the urinary mercury concentrations were 1.5 to 50 times higher than reference values. All patients presented with proteinuria and normal renal function; three had nephrotic syndrome. Light microscopy revealed thickened glomerular basement membrane and mildly proliferative mesangial cells. Acute tubulointerstitial injury occurred in three patients. The immunofluorescence findings showed granular deposits of IgG and C3 along the glomerular capillary wall, mostly accompanied by deposits of C4 and C1q. IgG1 and IgG4 (predominantly IgG1) deposits were observed along the glomerular capillary loops. Nine patients reached complete remission in follow-up after withdrawal from mercury exposure.
CONCLUSIONS: Deposits of IgG1 subclasses in renal tissues indicated that the pathogenesis of mercury-induced MN differs from that of idiopathic MN. It is important that clinicians are aware that mercury exposure should be considered a possible cause of membranous nephropathy.
Authors:
Shi-Jun Li; Su-Hua Zhang; Hui-Ping Chen; Cai-Hong Zeng; Chun-Xia Zheng; Lei-Shi Li; Zhi-Hong Liu
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Publication Detail:
Type:  Journal Article     Date:  2010-01-14
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  5     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-08     Completed Date:  2010-05-28     Revised Date:  2011-07-25    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  439-44     Citation Subset:  IM    
Affiliation:
Professor of Medicine, Research Institute of Nephrology, Jinling Hospital, Nanjing University School of Medicine, Nanjing 21002, China.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Biological Markers / urine
Biopsy
Complement System Proteins / analysis
Female
Fluorescent Antibody Technique
Glomerulonephritis, Membranous / chemically induced,  immunology,  pathology*,  therapy,  urine
Humans
Immunoglobulin G / analysis
Kidney Glomerulus / drug effects,  immunology,  pathology*
Male
Mercury / adverse effects*,  urine
Mercury Poisoning / immunology,  pathology*,  therapy,  urine
Middle Aged
Nephrotic Syndrome / chemically induced,  pathology
Proteinuria / chemically induced,  pathology
Retrospective Studies
Time Factors
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Immunoglobulin G; 7439-97-6/Mercury; 9007-36-7/Complement System Proteins
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