TOPIC DISCUSSION: Paraneoplastic Glomerulopathy

Paraneoplastic Glomerular Diseases: There are many of them
Membranous most common with solid tumors, MCD with most blood malignancies,
MPGN seen with CLL and blood malignancies, Ig A Nephropathy with lung and solid tumors, FSGS with Lymphoma, Crescentic GN usually with lung cancer and other solid tumors, Immunotactoid with CLL, AA amyloidosis with RCC, Bladder cancers.  The list can go on!!
How can one tell that the GN is paraneoplastic? Are there subtle clues?
The 4 ones that have been studied are:
1. Older age of presentation ( average age is 73 with Membranous Nephropathy with malignancy)
2. >20 years of smoking
3. Glomerular leukocyte infiltrate of >8 cells/glomerulus
4. Predominate IgG1 and IgG2

References:
http://www.ncbi.nlm.nih.gov/pubmed/6444922
http://www.ncbi.nlm.nih.gov/pubmed/3133055