Secondary polycythemia associated with idiopathic membranous nephropathy

A 58-year-old male patient had secondary polycythemia associated with idiop athic nephrotic syndrome. The renal biopsy revealed membranous nephropathy, and the bone marrow biopsy disclosed hypercellular marrow with mild panhyp erplasia. The concentration of serum erythropoietin was 8.5 mU/ml. The eryt hrocytosis was characterized by an increased red cell volume (40.2 ml/kg) a nd normal arterial oxygen saturation. There were no associated lesions that could induce secondary polycythemia, except the biopsy-proven membranous n ephropathy, He was treated with prednisolone and cyclophosphamide, and the nephrotic syndrome was partially remitted after 6 weeks. With partial remis sion of nephrotic syndrome, the erythrocytosis was resolved. This case illu strates the rarely reported association of the nephrotic syndrome and eryth rocytosis, and the resolution of erythrocytosis with improvement of nephrot ic syndrome. Copyright (C) 2000 S. Karger AG, Basel.