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The bronze kidney: membranous glomerulonephritis associated with iron overload

Arash Vaziri1, Adrian Jennings2, Verena Broecker3

  • 1Department of Gastroenterology, Lister Hospital, Stevenage, Hertfordshire, UK.

BMJ Case Reports
|February 18, 2015
PubMed

Insights

This study highlights a rare case of nephrotic syndrome caused by iron overload. Treatment with venesection effectively reduced edema and proteinuria, suggesting its utility in managing iron-related kidney disease.

Area of Science:

  • Nephrology
  • Hematology
  • Internal Medicine

Background:

  • Membranous glomerulonephritis (MGN) is a leading cause of nephrotic syndrome in adults.
  • Iron overload disorders can affect multiple organs, including the kidneys, but are rarely associated with MGN.
  • The interplay between iron metabolism and glomerular injury requires further investigation.

Observation:

  • A 55-year-old male with diabetes, hypertension, and hypercholesterolemia developed nephrotic syndrome.
  • Renal biopsy revealed membranous glomerulonephritis and increased iron deposition.
  • Elevated serum ferritin and transferrin saturation indicated iron overload, confirmed by liver biopsy.

Findings:

  • Genetic testing for common iron overload disorders was negative.
  • Interval venesection therapy led to significant improvement in edema and proteinuria.
  • This suggests a non-hereditary form of iron overload contributing to nephrotic syndrome.

Implications:

  • Iron overload should be considered in the differential diagnosis of nephrotic syndrome, even with negative genetic tests.
  • Venesection can be an effective treatment for iron overload-induced kidney disease.
  • Further research into non-HFE-related iron overload mechanisms in kidney disease is warranted.

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