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KMID : 0359919950140020228
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Korean Journal of Nephrology
1995 Volume.14 No. 2 p.228 ~ p.232
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A Case of Membranoproliferative Glomerulonephritis with Nephrotic syndrome Associated with Early Gastric Cancer
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이재성
송경일/차미경/김정호/박민선/진소영/한동철/이상구/황승덕
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Abstract
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The occurrence of nephrotic syndrome in association with neoplasia has been well documented in the literature. It is important to note that the occurrence of the nephrotic syndrome in patients over 45 years of age may be associated with occult
malignancy. The nephrotic syndrome may be the presenting sign of an otherwise occult neoplasm and older patients with idiopathic membranous nephrpathy in particular, should be carefully evaluated for malignancy.
We report a case of early gastric adenocarcinoma presenting as nephrotic syndrome due to membranoproliferative glomerulonephritis. After surgical resection, the proteinuria is remitted completely. The lesion most frequently found in patients with
nephrotic syndrome associated with the internal malignancy is membranous nephropathy, which led to speculation that the lesion is immunologically mediated. Although our patient demonstrated a membranoproliferative glomerulopathy histologically,
thus is
not inconsistent with such an association.
Circumstantial evidence favoring an immune mechanism includes remission of the nephrotic syndrome with treatment of the tumor, relapse of renal disease with recurrence of the lymphoma or malignancy and a temporal association between the diagnosis
of a
glomerulopathy and malignancy. The proposed pathogenesis of glomerular lesion in this setting includes circulating immune complex formed by specific tumor antigen.In our patient the nephrotic syndrome resolved after surgical removal of the tumor
thus
suggesting the causal relationship between cancer and the renal lesions.
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KEYWORD
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