par Richard, Carol;Dupont, Etienne ;Dupuis, Freddy
Référence Journal d'urologie et de néphrologie, 79, 9, page (745-748)
Publication Publié, 1973
Article révisé par les pairs
Résumé : Three case histories are presented of patients with a combination of nephrotic syndrome and bronchial cancer. In one case the symptom of proteinuria had preceded the tumoral symptoms by several months, but in the other two cases the two signs were associated from the start and the patients died rapidly from neoplastic generalization. In the first case the renal biopsy had shown optically normal glomeruli, and the proteinuria totally disappeared after several weeks of corticotherapy. In the 2nd case there was typical membranous glomerulonephritis and, in the 3rd case, extensive polynuclear exudation without proliferation or membranous deposits but associated with intracapillary thromboses. Immunofluorescence was not carried out in the first case, but in the other two it revealed extensive granular deposits of IgG, complement and fibrinogen. The postmortem examinations carried out in the last two cases excluded the possibility of amyloidosis or renal vein thrombosis. Nevertheless, the immunofluorescence data suggest the involvement of immune complexes. The absence of chemotherapy excluded the hypothesis of induced neoplasms. These observations suggest that the tumor tissues can constitute antigens which generate immune complexes responsible for the deposits on the glomerular basal membrane. This emphasizes the necessity of searching for neoplasms in patients with the nephrotic syndrome.