Membranous glomerulonephritis, dermatomyositis, and bronchial carcinoma.

Membranous glomerulonephritis, dermatomyositis, and bronchial carcinomaMembranous glomerulonephritis is associated with malignant disease in about 100°, of cases.'The prevalence of neoplasia in patients with dermatomyositis is estimated at 15-20%o in those aged over 45.2The occurrence of membranous glomerulonephritis with dermato- myositis is extremely unusual and in the one documented case malig- nancy was not implicated.3 Case reportA woman aged 58 years presented with ankle swelling and proteinuria..She smoked 20-30 cigarettes a day, was taking no medication, and was normotensive.Urine microscopy showed red cells with granular and cellular casts.The proteinuria was selective and amounted to 5-2 g/24 h.Serum con- centrations were as follows: albumnin 25 g/l, urea 6-8 mmol/l (41 mg/100 ml), and creatinine 129 /umol/l (1-46 mg/100 ml), ESR 50 mm in 1 h, and C3 1-28 U (0-8-1-4).A renal biopsy specimen showed diffuse capillary loop thickening and basement membrane spikes (figure).Immunofluorescence showed granular