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Tiopronin-induced membranous nephropathy: a case report.
[cystinuria]
Tiopronin
,
a
glycine
derivative
extensively
used
to
treat
cystinuria
and
hepatic
cell
injury
,
can
give
rise
to
rare
complications
such
as
proteinuria
and
nephrotic
syndrome
.
However
,
the
pathological
characteristics
of
this
secondary
nephropathy
are
poorly
understood
.
Here
,
we
report
a
case
of
tiopronin-induced
nephrotic
syndrome
.
A
65
-
year
-old
Chinese
man
with
a
history
of
myasthenia
gravis
admitted
tiopronin
for
hepatoprotection
therapy
.
After
3
months
later
,
he
presented
with
rapid
weight
gain
,
massive
peripheral
edema
,
and
proteinuria
in
the
nephrotic
range
.
Laboratory
findings
included
serum
albumin
(
20
g
/
L
)
,
total
protein
(
38
g
/
L
)
,
and
total
cholesterol
(
11
.
78
mmol
/
L
)
.
A
24
-
hour
urine
protein
collection
contained
8620
mg
.
Percutaneous
renal
biopsy
revealed
a
uniformly
thickened
glomerular
and
rigid
basement
membrane
with
immunoglobulin
G
(
IgG
)
and
complement
C
3
deposited
along
the
glomerular
capillary
wall
.
Withdrawal
of
tiopronin-induced
proteinuria
complete
remission
and
clinical
resolution
of
nephrotic
syndrome
.
Potential
risk
of
kidney
injury
exists
with
long
-term
tiopronin
treatment
.
Membranous
nephropathy
was
a
common
renal
pathologic
feature
.
Proteinuria
in
the
nephrotic
range
may
spontaneously
remit
after
tiopronin
withdrawal
.
Periodic
urine
analysis
and
patient
follow-up
are
recommended
with
tiopronin
therapy
.
Diseases
Validation
Diseases presenting
"total cholesterol"
symptom
acute rheumatic fever
adrenal incidentaloma
aromatase deficiency
classical phenylketonuria
cystinuria
oral submucous fibrosis
phenylketonuria
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