Search
causes of nephrotic syndrome
Etiology:
1) primary glomerular disease
- minimal change disease*
- mesangial proliferative glomerulonephritis (includes IgA nephropathy {Berger's disease})
- focal segmental glomerulosclerosis*
- membranous glomerulonephritis*
- membranoproliferative glomerulonephritis*
- type 1
- type 2
- other variants
- crescentic (rapidly progressive) glomerulonephritis
- uncommon disorders
- focal & segmental proliferative glomerulonephritis
- fibrillary &/or immunotactoid glomerulonephritis
2) secondary to non-glomerular disease
a) infections
- poststreptococcal glomerulonephritis*
- endocarditis
- shunt nephritis
- secondary syphilis
- leprosy
- hepatitis B*
- HIV infection (AIDS)
- infectious mononucleosis
- malaria
- schistosomiasis
- filariasis
b) pharmaceutical agents
- organic gold
- mercury (inorganic, organic, elemental)
- penicillamine
- street heroin
- non-steroidal anti-inflammatory drugs (NSAIDs)*
- probenecid
- captopril
- trimethadione (Tridione)
- mesantoin
- perchlorate
- antivenom
- antitoxins
- contrast media
c) neoplasms
- Hodgkin's disease
- lymphoma
- leukemia
- carcinomas
- melanomas
- Wilm's tumor
d) multisystem disorders
- systemic lupus erythematosus (SLE)*
- Henoch-Schonlein purpura*
- vasculitis
- Goodpasteur's disease
- dermatomyositis
- dermatitis herpeteformis
- amyloidosis*
- sarcoidosis
- Sjogren's syndrome
- rheumatoid arthritis
- mixed connective tissue disease
e) familial & hereditary disorders
- diabetes mellitus*
- Alport's syndrome
- sickle cell disease
- Fabry's disease
- nail-patella syndrome
- lipodystrophy
- lecithin-cholesterol acyltransferase deficiency
- congenital nephrotic syndrome
f) others
- pre-eclampsia
- thyroiditis
- myxedema
- morbid obesity
- renovascular hypertension
- chronic interstitial nephritis with vesicoureteric reflux
- chronic allograft rejection*
- hymenoptera sting
3) rare causes
a) fibrillary glomerulopathy
b) amyloidosis
c) light chain disease
d) pre-eclampsia
e) infectious disease
- bacterial
- post-streptococcal glomerulonephritis
- endocarditis
- syphilis
- viral
- hepatitis B & hepatitis C
- HIV
- protozoan - quartan malaria
- helminth
- schistosomiasis
- filariasis
- toxoplasmosis
f) cancer (minimal change & membranous glomerulonephritis)
g) systemic lupus erythematosus
h) familial syndromes
- Alport's syndrome
- nail-patella syndrome
i) immune reactions
- drugs
- gold
- penicillamine
- NSAIDs
- captopril
- interferon-alpha
- heroin
- environmental antigens
- poison ivy
- inhalation antigens
- bee-sting
* most common
Related
nephrotic syndrome
References
- Harrison's Principles of Internal Medicine, 13th ed.
Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 1300
- Orth & Ritz NEJM 33:1202-10, 1998