Membranous glomerulonephritis associated with industrial mercury exposure. Study of pathogenetic mechanisms

R. R. Tubbs, G. N. Gephardt, J. T. McMahon, M. C. Pohl, D. G. Vidt, S. A. Barenberg, R. Valenzuela

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

The nephrotoxicity associated with mercury may be manifested as either acute tubular necrosis or an immune complex glomerulonephritis, depending upon the conditions under which the patient is exposed to the metal. Two patients with industrial exposure to mercury developed the nephrotic syndrome due to membranous glomerulonephritis. A multidisciplinary approach was used to define more precisely the pathogenetic mechanisms involved in the production of the glomerular lesion. Although glomeruli were normal by light microscopy, immunohistochemical studies demonstrated confluent finely granular epimembranous deposits of IgG and C3. This distribution was confirmed at the ultrastructural level with immunoelectron microscopy. High resolution elemental analysis of electron dense inclusions in tubular epithelial phagolysosomes demonstrated energy dispersion spectra characteristic of coexisting mercury and selenium. Eluates from the biopsy material were not immunoreactive against normal rat or human kidney. There was no immunoreactivity of epimembranous deposits with antibodies having renal tubular epithelial antigen or urinary uromucoid specificity. These observations suggest that a distinctive immunopathologic lesion is associated with mercury-associated membranous glomerulonephritis, that the role of the metal itself may only be coincidental, and that the involved antigen remains unknown. Prednisone therapy had no documented persistent beneficial influence upon the level of proteinuria in one patient who has been lost to follow-up. In one patient not treated with steroid therapy, withdrawal of exposure to the metal resulted in disappearance of mercury from body fluids and clinical remission.

Original languageEnglish
Pages (from-to)409-413
Number of pages5
JournalAmerican Journal of Clinical Pathology
Volume77
Issue number4
StatePublished - Jun 22 1982
Externally publishedYes

Fingerprint

Membranous Glomerulonephritis
Mercury
Metals
Uromodulin
Implosive Therapy
Phagosomes
Immunoelectron Microscopy
Lost to Follow-Up
Nephrotic Syndrome
Body Fluids
Selenium
Glomerulonephritis
Prednisone
Antigen-Antibody Complex
Proteinuria
Microscopy
Necrosis
Immunoglobulin G
Steroids
Electrons

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Tubbs, R. R., Gephardt, G. N., McMahon, J. T., Pohl, M. C., Vidt, D. G., Barenberg, S. A., & Valenzuela, R. (1982). Membranous glomerulonephritis associated with industrial mercury exposure. Study of pathogenetic mechanisms. American Journal of Clinical Pathology, 77(4), 409-413.

Membranous glomerulonephritis associated with industrial mercury exposure. Study of pathogenetic mechanisms. / Tubbs, R. R.; Gephardt, G. N.; McMahon, J. T.; Pohl, M. C.; Vidt, D. G.; Barenberg, S. A.; Valenzuela, R.

In: American Journal of Clinical Pathology, Vol. 77, No. 4, 22.06.1982, p. 409-413.

Research output: Contribution to journalArticle

Tubbs, RR, Gephardt, GN, McMahon, JT, Pohl, MC, Vidt, DG, Barenberg, SA & Valenzuela, R 1982, 'Membranous glomerulonephritis associated with industrial mercury exposure. Study of pathogenetic mechanisms', American Journal of Clinical Pathology, vol. 77, no. 4, pp. 409-413.
Tubbs RR, Gephardt GN, McMahon JT, Pohl MC, Vidt DG, Barenberg SA et al. Membranous glomerulonephritis associated with industrial mercury exposure. Study of pathogenetic mechanisms. American Journal of Clinical Pathology. 1982 Jun 22;77(4):409-413.
Tubbs, R. R. ; Gephardt, G. N. ; McMahon, J. T. ; Pohl, M. C. ; Vidt, D. G. ; Barenberg, S. A. ; Valenzuela, R. / Membranous glomerulonephritis associated with industrial mercury exposure. Study of pathogenetic mechanisms. In: American Journal of Clinical Pathology. 1982 ; Vol. 77, No. 4. pp. 409-413.
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