Follow up strategies regarding cancer in Membranous Nephropathy
Patients with Membranous Nephropathy have an increased incidence of malignancy.
Therefore patients with Membranous Nephropathy should be regularly screened for the development of cancer. Age, smoking, and the presence of glomerular leukocytic infiltrates increase the likelihood of malignancy in these patients.
In patients with secondary Membranous Nephropathy due to malignancy, clinical remission of cancer is usually associated with a reduction of proteinuria.
Studies suggest an association between cancer-associated Membranous Nephropathy and presence of anti-THSDA-7a antibodies.
In the largest cohort of 25 patients with positive anti-THSDA-7a antibodies, 7 were found to have a malignant tumor.
This supports the hypothesis of molecular mimicry in which antibodies produced by the tumor cells recognize the related antigen expressed on podocytes.
Patients with Membranous Nephropathy and positive serology for anti-THSDA-7a antibody should be carefully screened for malignancy.