SMALL-CELL LUNG-CANCER, NEPHROTIC SYNDROM E AND RENAL-FAILURE OF RAPID EVOLUTION

There are different clinical manifestations and various types of glome rular damages associated to neoplasias. The association to nephrotic s yndrome is a relatively frequent event. However, rapidly evolutive ren al insufficiency with extensive crescentic glomerulonephritis in more than 50% of the glomeruli is not usually thought to be linked to malig nant diseases. We present the case of a previously healthy 55 year old man, who suffered a nephrotic syndrome and renal failure of rapid evo lution, in whom a small cell lung cancer was detected. He died in thre e months and at autopsy mesangial proliferation and enlargement of bas al membranes with crescents in 90% of the glomeruli were observed. Ele ctronic microscopy also showed enlargement of the basal membrane. Stru ctures consistent with immune-complex depositions were not seen. We re viewed the reported cases of glomerular lesions and neoplasias, and de scribed the 20 cases published with this particular type of glomerular lesions described for the first time in 1976. None of these 20 cases belongs to this variety of lung cancer. Only in 5 patients, rapidly ev olutive renal insufficiency was accompanied by nephrotic syndrome, as in the present case. The presence of immunocomplexes is not frequent a nd it was mentioned in only four cases. The only three cases of small cell lung carcinoma with nephrotic syndrome described in the literatur e were associated with membranous glomerulonephritis.