Thin Basement Membrane Disease Associated With Nephrotic Range Proteinuria, Hypertension and Chronic Kidney Disease

Abstract

Thin basement membrane disease (TBMD) is typically associated with hematuria but proteinuria is an uncommon presentation. When proteinuria is present, it is mostly in a non-nephrotic range, moreover, when proteinuria is in nephrotic range, generally it is associated with presence of glomerulopathies, Focal Segmental Nephrosclerosis, IgA Nephropathy or minimal change and is rarely present in an isolated TBMD. We present a case of 53-year-old male with history of hypertension for 15 yrs, coronary artery disease, rheumatoid arthritis and stage III chronic kidney disease who was referred to us for evaluation of long-standing chronic microscopic hematuria and new onset nephrotic range proteinuria. Given the fact that the proteinuria was new and in nephrotic range a biopsy was performed and was consistent with TBMD without other glomerlopathies or any other abnormalities seen. Our patient had CKD stage III serum (creatinine1.2 - 1.6 mg/dL), which was a stable finding for past 12 years. Microscopic hematuria was persistent for 24 years with new onset (6 month) of proteinuria. This case of TBMD is unique in terms of new onset nephrotic range proteinuria after long standing hematuria for 24 years.




doi: http://dx.doi.org/10.4021/wjnu97w