Khan Muhammad B, Kaur Amandeep, Ali Asad, Boris Avezbakiyev, Spitalewitz Samuel
Nephrology, Brookdale University Hospital Medical Center, Brooklyn, USA.
Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA.
Cureus. 2021 Sep 20;13(9):e18125. doi: 10.7759/cureus.18125. eCollection 2021 Sep.
A paraneoplastic syndrome, which includes glomerulopathy, is a manifestation of malignancy unexplained by direct tumor burden. Membranous nephropathy (MN) may be associated with malignancies that are primarily solid tumors of the lung, prostate and gastrointestinal tract. It is rarely associated with breast cancer. To our knowledge, we herein report the first case of MN associated with triple-negative carcinoma of the breast. The patient initially presented with MN as a paraneoplastic nephrotic syndrome. Treatment resulting in a complete pathological response of the breast cancer also resolved the MN. Neither has recurred after a 48-month follow-up. The patient exhibited autoantibodies against phospholipase A2 receptor and was also antinuclear antibody (ANA) and anti-Smith (anti-Sm) antibody positive. These results suggest that the neoplasm evoked an autoimmune response, which resolved with treatment. ANA and anti-SM positivity closely correlated with the neoplasm activity supporting this hypothesis.
副肿瘤综合征，包括肾小球病，是一种无法用直接肿瘤负荷解释的恶性肿瘤表现。膜性肾病（MN）可能与主要为肺、前列腺和胃肠道实体瘤的恶性肿瘤相关。它很少与乳腺癌相关。据我们所知，我们在此报告首例与三阴性乳腺癌相关的MN病例。该患者最初表现为MN，作为副肿瘤性肾病综合征。导致乳腺癌完全病理缓解的治疗也使MN得到缓解。在48个月的随访后均未复发。该患者表现出针对磷脂酶A2受体的自身抗体，并且抗核抗体（ANA）和抗史密斯（抗Sm）抗体也呈阳性。这些结果表明肿瘤引发了自身免疫反应，该反应通过治疗得到缓解。ANA和抗Sm阳性与肿瘤活动密切相关，支持这一假设。
