Nephrotic syndrome and mesenteric infarction secondary to metastatic mesothelioma

Our plain-English summary of Nephrotic syndrome and mesenteric infarction secondary to metastatic mesothelioma, by C.K. Farmer, D.J. Goldsmith (Postgraduate Medical Journal, 2001).

The study

• Authors: C.K. Farmer, D.J. Goldsmith
• Journal: Postgraduate Medical Journal
• Published: 2001;77(907):333-4
• Type of article: Case report
• Cited by: 12 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant mesothelioma can present insidiously with progressive breathlessness and chest pain. Paraneoplastic, or non-chest related, presentations are very rare. The case of an elderly man with occupational exposure to asbestos who presented with nephrotic syndrome due to minimal change nephropathy in the context of advanced pleural mesothelial malignancy is reported.

In plain English

This article was a case report about one patient. In late 1997 a 66 year old retired man was admitted with rapidly worsening swelling, breathlessness and extreme fatigue. He had worked as a telephone engineer until 1994, and the authors described him as undoubtedly exposed to asbestos. Tests showed urine protein of 30.0 g/l and plasma albumin of 15 g/l. After a kidney biopsy, doctors diagnosed nephrotic syndrome caused by minimal change nephropathy, a kidney disorder. He was treated with prednisolone and anticoagulants. He then developed acute small bowel obstruction and died in intensive care. At postmortem, tumour had largely replaced the left upper lobe of the lung. Tumour nodules were also found in the sac around the heart and in the brain. A 90 cm stretch of the small bowel (distal duodenum and proximal jejunum) had died from loss of blood supply (infarction). Tissue examination identified a sarcomatous pattern mesothelioma. The authors said the cause of the bowel infarction was not clear. They presented the case as minimal change nephropathy in association with metastatic pleurally based sarcomatous mesothelioma.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report
• Who was studied: One 66 year old retired man, admitted in late 1997
• Exposure: Occupational asbestos exposure as a telephone engineer until 1994. No fiber type or dose was given.
• Main results:
  • On admission the patient had proteinuria of 30.0 g/l and plasma albumin of 15 g/l
  • Kidney biopsy electron microscopy showed extensive foot process fusion and no immune deposits. Nephrotic syndrome secondary to minimal change nephropathy was diagnosed.
  • The patient developed acute small bowel obstruction, required mechanical ventilation and circulatory support, and died in the intensive care unit
  • At postmortem the left upper lobe of the lung was largely replaced by tumour
  • Two tumour nodules were found on the inner surface of the pericardial sac
  • 90 cm of distal duodenum and proximal jejunum were infarcted
  • Histology of the pleural, pericardial and brain nodules showed sheets of tumour cells. The tumour was concluded to be a sarcomatous pattern mesothelioma.
  • The authors stated that the cause of the bowel infarction was not clear
• The authors' conclusion: The authors presented the case as minimal change nephropathy in association with metastatic pleurally based sarcomatous mesothelioma.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Malignant Mesothelioma, Occupational Exposure.

Related studies

• An autopsy case of malignant pleural mesothelioma associated with nephrotic syndrome — S. Suzuki, M. Toyoshima, et al. (2014)
• Secondary renal amyloidosis associated with asbestos-related pleuropulmonary diseases — R. Shibata, T. Ozaki, et al. (2020)
• Epithelioid pleural mesothelioma concurrently associated with miliary pulmonary metastases and minimal change nephrotic syndrome - A hitherto undescribed case — Y. Tsukamoto, T. Otsuki, et al. (2015)
• Metastatic Malignant Peritoneal Mesothelioma Mimicking an Autoinflammatory Syndrome in a 12-Year-Old Boy — G. Olmedilla, C. Undaondo, et al. (2021)
• Metastatic biphasic pleural mesothelioma presenting with cauda equina syndrome — P. Pranay, V. Serafimov, et al. (2018)
• Rare cause of myocardial infarction, stroke, and lung tumour — M. Medvegy, A. Szekula, et al. (2013)

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