Immune-mediated glomerulonephritis after exposure to paraquat

Exposure to paraquat was followed 1 week later by mild respiratory distress in a previously healthy farmer who developed a mixed nephrotic/nephritic syndrome 3 months later. Percutaneous renal biopsy showed endo-extra-capillary proliferative glomerulonephritis associated with a linear pattern of IgG deposits along the glomerular capillary wall. This is the first case report of an association between exposure to a low dose of paraquat (as suggested by the mildness of the respiratory symptoms) and development of glomerulonephritis, possibly related to the occurrence of anti-glomerular basement membrane antibodies. The possibility is suggested that immune-mediated mechanisms of glomerular damage may be triggered by exposure to low-dose paraquat.