Membranous nephropathy secondary to Hashimoto's thyroiditis with positive PLA2R antibodies

Vizcarra-Vizcarra C.A.; Flores-Baldárrago A.F.; Chávez-Velásquez E.; Asato-Higa C. · Revista Cubana de Medicina Militar (2026)

Resumen

Introduction: The association between membranous nephropathy and Hashimoto's hypothyroidism is a rare condition involving immunological mechanisms such as immune complex deposition, cytokine production, and the direct effect of antibodies. Objective: To present a rare clinical case of membranous glomerulonephritis secondary to Hashimoto's thyroiditis with positive PLA2R antibodies. Clinical Case: A 62-year-old female patient with a history of type 2 diabetes mellitus and autoimmune hypothyroidism presented with hematuria, proteinuria, and no diabetic retinopathy. A renal biopsy was performed, which revealed membranous glomerulonephritis. It was classified as secondary due to the presence of C1q positive in immunofluorescence and the cause was attributed to Hashimoto's thyroiditis. Due to the persistence of proteinuria, even after correction of thyroid-stimulating hormone levels, PLA2R antibodies were requested, the result of which, paradoxically, was positive. Prednisone was started and the patient had a favorable outcome, with a reduction in proteinuria. Conclusions: Patients with diabetes mellitus and autoimmune hypothyroidism may develop membranous glomerulonephritis. A case of membranous nephropathy secondary to Hashimoto's thyroiditis with positive PLA2R antibodies and good response to corticosteroids is reported.

Instituciones: Universidad Nacional de San Agustín de Arequipa; Universidad Católica de Santa María