Glomerulopathy as a paraneoplastic phenomenon

A review is presented of the association between a glomerular disease and a malignancy. The incidence of Hodgkin's disease in patients with glomerulopathy is very low, but the incidence of a solid tumour in a patient with glomerulopathy varies between 3 and 13%, mean 7%, and may be as high as 22% in patients over 60 years of age with a membranous nephropathy. A solid tumour was found most frequently in patients with membranous nephropathy. On the other hand, minimal change nephropathy is often associated with Hodgkin's disease and membrano-proliferative glomerulopathy with chronic lymphatic leukaemia. In Hodgkin's disease-associated glomerulopathy, a defect in the function of T lymphocytes is probably important, but the precise pathogenesis has not yet been elucidated. The other glomerulopathies may be mediated by immune complexes, containing tumour-derived antigens and their antibodies, either formed in situ or deposited as complexes from the circulation.