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Official publication of the Indian Society of Nephrology
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Nell1 as Target Antigen for Mercury Related Membranous Nephropathy: A Case Report

1 Department of Nephrology, Pondicherry Institute of Medical Science, Pondicherry, India
2 Department of Pathology, Pondicherry Institute of Medical Science, Pondicherry, India
3 Department of Biochemistry, Pondicherry Institute of Medical Science, Pondicherry, India

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No. 34, Church Street, Shivaji Nagar, Puducherry
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijn.ijn_415_21

Membranous nephropathy constitutes 30% of adult nephrotic syndrome. Of all cases of membranous nephropathy, primary membranous nephropathy is commonest. Mercury is known to be a cause of secondary membranous nephropathy. There is no human data on the pathophysiology of mercury-related membranous nephropathy, but animal studies suggested an autoimmune mechanism behind it. There is no data to the best of our knowledge about target antigen for mercury-related membranous nephropathy. We are reporting a case of NELL-1 positive mercury-related membranous nephropathy that started resolving after stopping siddha medication and taking antiproteinuric. There was also concomitant euthyroid lymphocytic thyroiditis with anti-TPO positive, which started after exposure to siddha medication, which suggests systemic autoimmune phenomenon due to mercury exposure.

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Indian Journal of Nephrology
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Online since 20th Sept '07