Is there an association of Minimal Change Nephrotic Syndrome and Hashimoto Thyroiditis? Martine K.F. Docx 1, Johan Vande Walle 2 1 Department of Paediatrics Chronic Diseases Queen Paola Children’s Hospital Antwerp Belgium 2 Department of Paediatric Nephrology and Rheumatology, Safepedrug, Ghent University Hospital,

1. Introduction  The association of renal disease with autoimmune thyroid disorders has been reported previously.  The rare association between glomerular disease and Hashimoto thyroiditis may be hypothesized to cross-reacting antigens.  In the case of mesangioproliferative glomerulonephritis the target antigen may be thyroglobulin or another thyroid-released antigen that will give deposits in the glomerulus. Other glomerular diseases associated with Hashimoto’s thyroiditis were mentioned in the literature: IgA nephropathy, membranoproliferative glomerulonephritis,focal segmental glomerulosclerosis and amyloidosis.  Other glomerular diseases associated with Hashimoto’s thyroiditis were mentioned in the literature: IgA nephropathy, membranoproliferative glomerulonephritis,focal segmental glomerulosclerosis and amyloidosis.

2.Patients

3.Discussion and Hypothesis: Are there Similar Mechanisms in the Pathogenesis in Nephrotic Syndrome (NS) & Hashimoto Thyroiditis ( HS)? FIG. 1: Adapted from Changli Wei and Jochen Reiser. Nephrol Dial Transplant, 2011 PATHOGENESIS OF IDIOPATHIC NS FIG. 1: Adapted from Changli Wei and Jochen Reiser. Nephrol Dial Transplant, 2011 PATHOGENESIS OF IDIOPATHIC NS FIG. 1: Adapted from Changli Wei and Jochen Reiser. Nephrol Dial Transplant, 2011 PATHOGENESIS OF IDIOPATHIC NS Adapted from Changli Wei and Jochen Reiser. Nephrol Dial Transplant, 2011 PATHOGENESIS OF IDIOPATHIC NS

3.Discussion and Hypothesis: Are there Similar Mechanisms in the Pathogenesis in Nephrotic Syndrome (NS) & Hashimoto Thyroiditis Nephrotic Syndrome Hashimoto Thyroiditis Fig 2: Adapted from PATHOGENESIS AND GENETICS OF NS by Dr. Aditi Sinha and Dr. Arvin Bagga: An imbalance of Th17 and T regulatory responses allows persistent CD80 activation on podocytes and/or helper responses. Adapted from PATHOGENESIS AND GENETICS OF NS by Dr. Aditi Sinha and Dr. Arvin Bagga: An imbalance of Th17 and T regulatory responses allows persistent CD80 activation on podocytes and/or helper responses. Adapted from: Bossowski et al. demonstrated an elevated level of Th17 cells in children with untreated Hashimoto’s disease, which suggests the participation of these cells in the induction and development of the disease.

4. Discussion  1.Patients with pediatric nephrotic syndrome were found to have an increased number of Th17 cells.  2.Wang et al. concluded that Th17/IL17 may contribute to the pathogenesis of PNS by decreasing the podocalyxin level and inducing monocyte apoptosis.  3.In Hashimoto thyroiditis histopathological examinations showed a relationship between the concentration of IL17 and stromal fibrosis.

5.Conclusions  Th17 lymphocytes serve as a pathogenic factor in the development of various autoimmune diseases.  A possible hypothesis could be the increased number of Th17 cells we found in both diseases what a possible explanation might be for the association of Minimal Change Nephrotic Syndrome and Hashimoto Thyroiditis in our patients.  Further research is needed.