Acute kidney injury associated with glomerulopathy and paraneoplastic pulmonary thromboembolism in pulmonary adenocarcinoma
DOI:
https://doi.org/10.33448/rsd-v15i2.50558Keywords:
Paraneoplastic Glomerulopathy, Acute Kidney Injury, Lung Neoplasms, Onconephrology.Abstract
Introduction: Paraneoplastic Glomerulopathies (PGN) are renal manifestations secondary to extrarenal solid or hematological malignancies, with a progressive increase in recognition over recent years. Their diagnosis and management remain challenging due to the variable temporal relationship between renal manifestations and cancer diagnosis, often resulting in delayed recognition and high morbidity and mortality. Objective: To report a case of probable paraneoplastic glomerulopathy associated with lung adenocarcinoma, complicated by acute kidney injury and pulmonary embolism, highlighting diagnostic and therapeutic challenges in a resource-limited setting. Methodology: This is a case report developed in accordance with the CARE guidelines, based on data collected from electronic medical records and supported by a narrative literature review for clinical contextualization. Results: A 49-year-old male patient with a recent diagnosis of lung adenocarcinoma developed pulmonary embolism, significant proteinuria, hematuria with dysmorphic erythrocytes, and acute kidney injury requiring renal replacement therapy. The inability to perform a renal biopsy led to a presumptive diagnosis of paraneoplastic glomerulopathy. Discussion: This case illustrates the complex interplay between malignancy, a prothrombotic state, and glomerular involvement, reinforcing the importance of clinical suspicion and a multidisciplinary approach. Clinical presentation, diagnostic strategies, therapeutic interventions, and clinical evolution are discussed in light of current scientific evidence. Conclusion: Early recognition of glomerular involvement in oncological patients may significantly influence prognosis, even in the absence of histological confirmation.
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