Summary
The results of electron microscopic examination of renal biopsies from 3 patients with rheumatoid arthritis treated with penicillamine are presented. All 3 patients developed a nephrotic syndrome upon discontinuation of penicillamine therapy. When viewed with the electron microscope, segmental forms of perimembranous glomerulonephritis (Stages I–II of Ehrenreich and Churg) and glomerular renal amyloidosis Grade I–III were observed. In all three cases the nephrotic syndrome was considered to be due to the simultaneous occurrence of the two disease processes. In 2 cases perimembranous glomerulonephritis with immuno-complex-deposits was assumed to be the dominant factor in the causation of the disease, in the other case amyloidosis was the principle abnormality.
Similar content being viewed by others
References
Bryde, M., Missmahl, H.P.: Therapie der generalisierten Amyloidosen. Therapiewoche 37, 5051–5064 (1975)
Ehrenreich, T., Churg, J.: Pathology of membranous nephropathy sommer's Pathology Annual. Vol. II, pp. 145–186 New York: Appleton-Century-Crofts 1968
GÄrtner, H.-V., Neild, G.H., Bohle, A., Hallauer, W., Hoppe-Seyler, G., Lüttgen, F.M., Schollmeyer, P.: Perimembranöse Glomerulonephritis nach Penicillamintherapie Klin. Wschr. 53, 835–837 (1975)
GÄrtner, H.-V., Watanabe, T., Ott, V., Adam, A., Bohle, A., Edel, H.H., Kluthe, R., Renner, E., Scheler, F., Schmülling, R.M., Sieberth, H.-G.: Correlations between Morphology anc Clinical Features in Idiopathic Perimembranous Glomerulonephritis Current Topics in Pathology. 65, 1–29 Berlin-Heidelberg-New York: Springer-Verlag, 1977
Gise, H. v., Mikeler, E., Gruber, M., Christ, H., Bohle, A.: Investigation on the cause of the nephrotic syndrome in glomerular amyloidosis. Electronmicroscopic Research. In press
Lake, B., Andrews, G.: Rheumatoid arthritis with secondary amyloidosis and malabsorption syndrome. Effects of D-Penicillamine. Am. J. Med. 44, 105–115 (1968)
Watanabe, T., Saniter, T.: Morphological and clinical features of renal amyloidosis Virchows Arch. (Pathol. Anat.) 366, 125 (1975)
Wright, J.R., Ozdemir, A.I., Matsuzaki, M., Binette, P., Calkins, E.: Amyloid resorption: Possible role of multinucleated giant cells. The apparent failure of Penicillamine treatment. Hopkins Med. J. 130, 278–288 (1972)
Author information
Authors and Affiliations
Additional information
Supported by the Deutsche Forschungsgemeinschaft
With the technical assistance of E. Mikeler
Rights and permissions
About this article
Cite this article
Bohle, A., Fischbach, H., GÄrtner, H.V. et al. Simultaneous occurrence of perimembranous glomerulonephritis and glomerular amyloidosis. Virchows Arch. A Path. Anat. and Histol. 378, 315–320 (1978). https://doi.org/10.1007/BF00465597
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00465597