Document Detail


Pathogenesis, diagnosis and management of paraneoplastic glomerulonephritis.
MedLine Citation:
PMID:  21151207     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Paraneoplastic glomerulonephritis is a rare complication of malignancy that is frequently mistaken for idiopathic glomerulonephritis. Failure to recognize paraneoplastic glomerulonephritis can subject patients to ineffective and potentially harmful therapy. The pathology of paraneoplastic glomerulonephritis varies between different types of malignancies. This Review discusses the association of glomerulonephritis with both solid tumors and hematological malignancies. The pathogenetic mechanisms of many glomerular lesions seem to relate to altered immune responses in the presence of a malignancy. Studies in the Buffalo/Mna rat model of spontaneous thymoma and nephrotic syndrome indicate that polarization of the immune response toward a T-helper-2 (T(H)2) profile has an important role in the development of thymoma-associated glomerular lesions. Furthermore, overexpression of the T(H)2 cytokine interleukin 13 in rats induces minimal change disease. Such findings from experimental studies might facilitate the identification of biomarkers that can distinguish paraneoplastic glomerulonephritis from idiopathic and other secondary glomerulonephritides. This Review describes potential pathogenetic mechanisms for paraneoplastic glomerulonephritides associated with different malignancies and highlights the need for a multidisciplinary approach to the management of patients with paraneoplastic glomerulonephritis.
Authors:
Yeong-Hau H Lien; Li-Wen Lai
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Review     Date:  2010-12-14
Journal Detail:
Title:  Nature reviews. Nephrology     Volume:  7     ISSN:  1759-507X     ISO Abbreviation:  Nat Rev Nephrol     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-31     Completed Date:  2011-05-24     Revised Date:  2014-09-14    
Medline Journal Info:
Nlm Unique ID:  101500081     Medline TA:  Nat Rev Nephrol     Country:  England    
Other Details:
Languages:  eng     Pagination:  85-95     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Glomerulonephritis* / diagnosis,  etiology,  therapy
Humans
Neoplasms / complications*
Paraneoplastic Syndromes* / complications,  diagnosis,  therapy
Grant Support
ID/Acronym/Agency:
R01 DK082718/DK/NIDDK NIH HHS; R01 DK082718-01A2/DK/NIDDK NIH HHS; R01 DK082718-02/DK/NIDDK NIH HHS; R01 DK082718-03/DK/NIDDK NIH HHS; R01DK082718/DK/NIDDK NIH HHS
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