Reactions 1163 - 4 Aug 2007

SProbenecid

Membranous nephropathy in an elderly patient:case report

A 79-year-old man developed membranous nephropathyduring treatment with probenecid for gout.

The man, who had been receiving probenecid 500mg twicedaily for the previous year, was admitted for pitting oedema.One month earlier, his daily probenecid dose had beenincreased to 1500mg due to an increased uric acid level. Grosspitting oedema and further weight gain was observed 2 weekslater. Urinalysis showed 4+ protein, and his 24h proteinexcretion was 5.5g; he had a serum albumin level of 2.2 g/dL.Microscopy of a renal biopsy specimen showed rigid andminimally thickened capillary loops. Patchy thickening of theglomeruli basement membrane was confirmed by sliver stain,and strong membranes and fine granular IgG deposits wereobserved on immunofluorescence. A diagnosis ofmembranous nephropathy was made.

Probenecid was discontinued and, within 6 weeks, theman’s oedema and proteinuria resolved.

Author comment: "In our patient case, the nephroticsyndrome remission might be explained by the naturalevolution of [membranous nephropathy]. However, the factthat proteinuria appeared 15 days following the introductionof treatment, and disappeared 6 weeks after stopping, lead usto believe that a cause-effect relationship between the drugand the clinical profile exists."Izzedine H, et al. Probenecid-induced membranous nephropathy. NephrologyDialysis Transplantation 22: 2405-2406, No. 8, Aug 2007 - France 801091164

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Reactions 4 Aug 2007 No. 11630114-9954/10/1163-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved