Hashimoto's thyroiditis and membranous nephropathy developed in progressive systemic sclerosis (PSS)

A case of a 36-year-old woman with progressive systemic sclerosis (PSS) was reported. The patient had two additional immune-mediated diseases: Hashimoto's thyroiditis and membranous nephropathy. It was implicated that overlapping of systemic lupus erythematosus (SLE) occurred in the course of PSS. Notably, immune complex deposition along the follicular basement lamina of the thyroid was suggested by immunofluorescence and electron microscopy. Although the glomerular lesion was in general accord with membranous nephropathy, it was complicated by occasional crescent formations and necrotic arterial changes, probably resulting from malignant hypertension that appeared during the terminal stage. It was implied that the same circulating antigen-antibody complexes might have been involved in the pathogenesis of Hashimoto's thyroiditis and membranous nephropathy in this case.