GLOMERULONEPHRITIS ASSOCIATED WITH MYASTHENIA-GRAVIS

In a follow-up study of 128 myasthenic patients from a neurological ce nter in Northern Italy, three were found to have developed glomerulone phritis at variable intervals after the onset of myasthenia gravis, th ymoma (two patients), and thymectomy, By renal biopsy, two patients (c ases 1 and 3) were found to have membranous nephropathy; and one (case 2), pauciimmune extracapillary glomerulonephritis. At follow up, pati ent 1 was persistingly nephrotic and developed renal failure, and pati ent 3 only had urinary abnormalities, Patient 2 developed end-stage re nal disease. The review of the literature showed 10 other cases of glo merulonephritis associated with myasthenia gravis with or without thym oma and thymectomy, Therefore, it is likely that these conditions are pathogenetically linked. The role of autoantibodies, thymoma, and thym ectomy in favoring glomerulonephritis in myasthenic patients is discus sed. (C) 1998 by the National Kidney Foundation, Inc.