A case of Graves' disease associated with membranoproliferative glomerulonephritis and leukocytoclastic vasculitis

Journal of Pediatric Endocrinology & Metabolism : JPEM
Werner KeenswijkJohan Vande Walle

Abstract

Background The association of hyperthyroidism with renal disease is very rare and the importance of timely clinical recognition cannot be overemphasized. Case presentation An 11-year-old girl presented with gastrointestinal symptoms while hypertension, edema and abdominal pain were noticed on clinical examination. Laboratory investigation revealed: hemoglobin 9.4 (11.5-15.5) g/dL, total white cell count 16 (4.5-12)×109/L, platelets 247 (150-450)×109/L, C-reactive protein (CRP) 31.8 (<5) mg/L, blood urea nitrogen (BUN) 126 (13-43) mg/dL, creatinine 0.98 (0.53-0.79) mg/dL, albumin 25 (35-52) g/dL, complement factor C3 0.7 (0.9-1.8) g/L, complement factor C4 0.1 (0.1-0.4) g/L, tri-iodothyronine 6.5 (2.5-5.2) pg/mL, free thyroxine 2.4 (1-1.7) ng/dL, thyroid stimulating hormone (TSH) <0.02 (0.5-4.3) mU/L. Urinalysis showed nephrotic range proteinuria. Renal function deteriorated necessitating hemodialysis (HD). A renal biopsy revealed an immune complex-mediated membranoproliferative glomerulonephritis (MPGN). Elevated thyroid hormones and suppressed TSH levels with elevated thyroperoxidase antibodies and thyroid stimulating immunoglobulins confirmed the diagnosis of Graves' disease. Corticosteroids were commenced and eventually thia...Continue Reading

References

Jul 1, 1985·Acta Endocrinologica·A P WeetmanA M McGregor
Feb 1, 1995·Kidney International·H G Rennke
Aug 1, 1994·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·S ItoT Ichimura
Mar 20, 2004·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Omer DizdarCetin Turgan
Nov 3, 2004·Journal of Hepatology·Marta Martín, Manel Solé
Nov 17, 2007·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Sevgi GurkanM Jeffrey Saland
Mar 23, 2012·The New England Journal of Medicine·Sanjeev Sethi, Fernando C Fervenza
Feb 7, 2014·Journal of Nephrology·Ladan ZandSanjeev Sethi
Feb 20, 2016·Molecular and Cellular Biochemistry·Gudrun Caspar-BellKailash Prasad

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Citations

Mar 8, 2019·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Aydilek Dagdeviren CakirOlcay Evliyaoglu
Mar 8, 2019·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Aydilek Dagdeviren CakirOlcay Evliyaoglu

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