Pestana Nicole, Vida Carlota, Vieira Pedro, Durães José, Silva Gil
Nephrology Department, Hospital Central do Funchal, Funchal, PRT.
Cureus. 2021 Feb 12;13(2):e13312. doi: 10.7759/cureus.13312.
Membranous nephropathy is the most common cause of nephrotic syndrome in adults. A non-negligible number of cases are associated with systemic conditions. We report a case of a 50-year-old man who presented with nephrotic syndrome six months after being diagnosed with celiac disease. Although the patient showed disappearance of circulating immunoglobulin A (IgA) anti-tissue transglutaminase antibodies following a gluten-free diet, he had a sudden onset of nephrotic syndrome presenting with severe hypoalbuminemia. Other secondary causes were promptly excluded leading to the assumption of celiac disease-associated membranous nephropathy with remission after treatment with angiotensin system blockade and a gluten-free diet. The goal of this case report is to alert the clinic towards this rare association aiming for an early diagnosis and adequate selection of long-term therapy.
膜性肾病是成人肾病综合征最常见的病因。相当数量的病例与全身性疾病有关。我们报告一例50岁男性病例,该患者在被诊断为乳糜泻6个月后出现肾病综合征。尽管患者在采用无麸质饮食后循环免疫球蛋白A(IgA)抗组织转谷氨酰胺酶抗体消失,但他突然出现肾病综合征,伴有严重低白蛋白血症。其他继发原因被迅速排除,从而推测为乳糜泻相关的膜性肾病,经血管紧张素系统阻断治疗和无麸质饮食后病情缓解。本病例报告的目的是提醒临床注意这种罕见的关联,以便早期诊断并合理选择长期治疗方案。