Medical Case Reports

Proteinuria Associated with Thyroid Disorders - Cases Report and Literature Review

Background: The interactions between thyroid and kidney have been reported mainly in the patients with proteinuria coexistent with autoimmune thyroiditis. The proposed mechanisms focus on direct effects of thyroid hormone on the hemodynamics and morphology of kidney and indirect effects through deposition of immune complexes consisting of thyroid component.

Case presentation: Herein we describe two cases presenting with proteinuria associated with thyroid disorder. Both patients presented with nephrotic-range proteinuria and hematuria but were not responsive to immunosuppression therapy. Immunopathology demonstrated the deposits of multiple immunoglobulins and complements along glomerular basement membrane and mesangium. One case presented with mesangial proliferative glomerulonephritis (MsPGN) in the context of thyroid papillary carcinoma. After removal of tumor, the urine protein disappeared. This is the first report about the MsPGN related to thyroid tumor. The other case was diagnosed as MN secondary to Hashimoto’s thyroiditis. More interestingly, both patients suffered relapse of the proteinuria accompanied by opposed disturbance of thyroid hormone at the follow-up. Once the thyroid hormone was corrected, the renal function improved.

Conclusion: This study proposes a possibility that a hormone-cytokine axis connecting these two organs mediates the changes of microenvironment in kidney with the thyroid hormone change, and then influence the renal function.

Author(s):

Yaxin Hao, Xiaomei Wu, Xiao Huang and Zheng Tang

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