CARCINOID-TUMOR AND THE NEPHROTIC SYNDROME - A NOVEL ASSOCIATION BETWEEN NEOPLASIA AND GLOMERULAR-DISEASE

Various malignancies are associated with the paraneoplastic evolution of the nephrotic syndrome, Renal biopsy in these instances frequently shows membranous glomerulonephritis. We describe a patient who had met astatic bronchial carcinoid tumor with development of microscopic hema turia and subsequent nephrotic syndrome in conjunction with another pa raneoplastic process, a malignancy-related neuropathy. A decline in ac tual glomerular filtration rate led to percutaneous renal biopsy, whic h revealed fine holes in the glomerular basement membrane and focal ca pillary corrugation. Electron microscopy showed numerous small subepit helial dense deposits and fusion of foot processes, confirming the dia gnosis of stage I membranous nephropathy, We believe this is the first published case of true carcinoid tumor associated with the nephrotic syndrome and a specific paraneoplastic glomerular lesion. Carcinoid tu mor should be considered in the spectrum of malignancies associated wi th paraneoplastic development of the nephrotic syndrome.