[Membranoproliferative glomerulonephritis associated with autoimmune thyroiditis]

Several cases of glomerular disease have been associated to thyroid diseases. The most frequent lesion described is membranous glomerulopathy, presented as a nephrotic syndrome. Here we report a 67-year-old man who developed a nephrotic syndrome accompanied by rapid derangement of renal function shortly after the onset of a primary hypothyroidism due to autoimmune thyroiditis. High titers of circulating anti-thyroglobulin and anti-microsomal thyroid antigen antibodies were detected. Serum levels of C3 and C4 fractions of complement were markedly decreased. Renal biopsy showed a membranoproliferative glomerulonephritis with severe mesangial proliferation, a type of glomerular involvement non-described previously in the literature, in relation with thyroid diseases. Four boluses of intravenous steroids were administered, followed by oral prednisone for three months. A dramatic recovery of renal function, together with normalization of urinary sediment, proteinuria decrease and normalization of serum complement were observed. Three years later, the patient suffered from a similar event, with a positive response to steroids again. One year later, the patient had a new recurrence and was treated with mycophenolate mofetil , improving his clinical situation.