{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T14:02:27Z","timestamp":1778594547757,"version":"3.51.4"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2021,1,11]],"date-time":"2021-01-11T00:00:00Z","timestamp":1610323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"American Heart Association Scientist Development","award":["17SDG33660947"],"award-info":[{"award-number":["17SDG33660947"]}]},{"DOI":"10.13039\/100016206","name":"UCLA CTSI","doi-asserted-by":"publisher","award":["KL2TR001882"],"award-info":[{"award-number":["KL2TR001882"]}],"id":[{"id":"10.13039\/100016206","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Cedars-Sinai CTSI Clinical Scholar"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,30]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Nephropathy in patients with thymic diseases such as thymoma and myasthenia gravis (MG) is rare and has been described mostly as isolated case reports. Here we evaluate a series of kidney biopsies from patients with thymoma and\/or MG from a single institution in order to better define the spectrum and relative frequencies of thymic disease\u2013associated nephropathies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective case series study of 32\u2009462 native kidney biopsies from January 2005 through December 2019 at Cedars-Sinai Medical Center, Los Angeles, CA, USA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty-four biopsy specimens (0.07%) from patients with a history of thymoma and\/or MG were identified. Two patients had repeat biopsies. The most common pathologic diagnosis that could be immunologically attributed to thymic disease was minimal change disease (MCD; 45%), followed by tubulointerstitial nephritis (TIN; 14%), immune complex (IC)-mediated glomerulonephritis (9%), membranous nephropathy (5%) and immunoglobulin A (IgA) nephropathy (5%). Interestingly, 50% of the MCD and 67% of TIN cases concomitantly showed mild IgG-dominant IC deposition in mesangial areas and\/or in tubular basement membranes. In the two patients with repeat biopsies, mild mesangial IC deposition developed in the MCD patient but disappeared in the TIN patient with the second biopsy. Pathologic diagnoses unlikely related to the underlying thymic disease were diabetic glomerulosclerosis (9%), acute tubular necrosis (9%) and monoclonal Ig deposition disease (5%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Thymic disease is associated with a wide spectrum of kidney diseases affecting the glomerular and tubulointerstitial compartments, often with low-grade IC deposition. These findings suggest a role of immunologic dysregulation in the pathogenesis of thymic disease\u2013associated nephropathy.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ckj\/sfaa276","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T20:13:42Z","timestamp":1608668022000},"page":"2090-2100","source":"Crossref","is-referenced-by-count":4,"title":["The histopathological spectrum of kidney biopsies in patients with thymoma and myasthenia gravis: a report of 24 biopsies from a single institution"],"prefix":"10.1093","volume":"14","author":[{"given":"Akira","family":"Takahashi","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA"},{"name":"Department of Nephrology, Hiroshima University Hospital, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takamasa","family":"Miyauchi","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Narihito","family":"Tatsumoto","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mercury Y","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiki","family":"Doi","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hiroshima University Hospital, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takao","family":"Masaki","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hiroshima University Hospital, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6221-8900","authenticated-orcid":false,"given":"Michifumi","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,1,11]]},"reference":[{"key":"2022030407592575500_sfaa276-B1","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.autrev.2015.09.005","article-title":"Thymoma associated with autoimmune diseases: 85 cases and literature review","volume":"15","author":"Bernard","year":"2016","journal-title":"Autoimmun Rev"},{"key":"2022030407592575500_sfaa276-B2","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1001\/archinte.1974.00320200184029","article-title":"The spectrum of diseases associated with thymoma. Coincidence or syndrome?","volume":"134","author":"Souadjian","year":"1974","journal-title":"Arch Intern Med"},{"key":"2022030407592575500_sfaa276-B3","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1007\/s00595-012-0318-2","article-title":"Thymus, thymoma and myasthenia gravis","volume":"43","author":"Fujii","year":"2013","journal-title":"Surg Today"},{"key":"2022030407592575500_sfaa276-B4","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1038\/ki.2012.484","article-title":"Glomerular diseases seen with cancer and chemotherapy: a narrative review","volume":"84","author":"Jhaveri","year":"2013","journal-title":"Kidney Int"},{"key":"2022030407592575500_sfaa276-B5","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s40620-015-0234-9","article-title":"Glomerular diseases and cancer: evaluation of underlying malignancy","volume":"29","author":"Pani","year":"2016","journal-title":"J Nephrol"},{"key":"2022030407592575500_sfaa276-B6","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1159\/000409763","article-title":"IgA mesangial nephropathy in neoplastic diseases","volume":"40","author":"Mustonen","year":"1984","journal-title":"Contrib Nephrol"},{"key":"2022030407592575500_sfaa276-B7","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/S0046-8177(83)80016-1","article-title":"Renal cell carcinoma and systemic amyloidosis: demonstration of AA protein and review of the literature","volume":"14","author":"Vanatta","year":"1983","journal-title":"Hum Pathol"},{"key":"2022030407592575500_sfaa276-B8","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1038\/nrneph.2010.171","article-title":"Pathogenesis, diagnosis and management of paraneoplastic glomerulonephritis","volume":"7","author":"Lien","year":"2011","journal-title":"Nat Rev Nephrol"},{"key":"2022030407592575500_sfaa276-B9","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1002\/1097-0142(19800115)45:2<387::AID-CNCR2820450233>3.0.CO;2-Z","article-title":"Thymoma and the nephrotic syndrome: a report of a case","volume":"45","author":"Posner","year":"1980","journal-title":"Cancer"},{"key":"2022030407592575500_sfaa276-B10","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1001\/archinte.1984.00350160117020","article-title":"Disorders of the thymus. A review","volume":"144","author":"Rosenow","year":"1984","journal-title":"Arch Intern Med"},{"key":"2022030407592575500_sfaa276-B11","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1093\/ndt\/gfh615","article-title":"Renal and thymic pathology in thymoma-associated nephropathy: report of 21 cases and review of the literature","volume":"20","author":"Karras","year":"2005","journal-title":"Nephrol Dial Transplant"},{"key":"2022030407592575500_sfaa276-B12","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.kint.2020.06.014","article-title":"The clinicopathologic spectrum of segmental membranous glomerulopathy","volume":"99","author":"Kudose","year":"2020","journal-title":"Kidney Int"},{"key":"2022030407592575500_sfaa276-B13","volume-title":"WHO Classification of Tumours of the Lung, Pleura, Thymus and Heart","author":"Travis","year":"2015"},{"key":"2022030407592575500_sfaa276-B14","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.jtho.2017.11.118","article-title":"Paraneoplastic syndromes and thymic malignancies: an examination of the international thymic malignancy interest group retrospective database","volume":"13","author":"Padda","year":"2018","journal-title":"J Thorac Oncol"},{"key":"2022030407592575500_sfaa276-B15","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.clim.2010.01.006","article-title":"Good\u2019s syndrome remains a mystery after 55 years: a systematic review of the scientific evidence","volume":"135","author":"Kelesidis","year":"2010","journal-title":"Clin Immunol"},{"key":"2022030407592575500_sfaa276-B16","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1007\/s00277-008-0693-3","article-title":"Cellular and humoral immune alterations in thymectomized patients for thymoma","volume":"88","author":"Lalle","year":"2009","journal-title":"Ann Hematol"},{"key":"2022030407592575500_sfaa276-B17","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1038\/nri1781","article-title":"Journey through the thymus: stromal guides for T-cell development and selection","volume":"6","author":"Takahama","year":"2006","journal-title":"Nat Rev Immunol"},{"key":"2022030407592575500_sfaa276-B18","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1016\/j.it.2017.07.010","article-title":"The mechanisms of T cell selection in the thymus","volume":"38","author":"Takaba","year":"2017","journal-title":"Trends Immunol"},{"key":"2022030407592575500_sfaa276-B19","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1016\/j.immuni.2019.04.011","article-title":"T follicular helper cell biology: a decade of discovery and diseases","volume":"50","author":"Crotty","year":"2019","journal-title":"Immunity"},{"key":"2022030407592575500_sfaa276-B20","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1177\/096120339500400108","article-title":"Appearance of systemic lupus erythematosus after thymectomy: four case reports and review of the literature","volume":"4","author":"Mevorach","year":"1995","journal-title":"Lupus"},{"key":"2022030407592575500_sfaa276-B21","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.1016\/S0272-6386(99)70444-0","article-title":"Thymoma associated with myasthenia gravis and minimal lesion nephrotic syndrome","volume":"33","author":"Lasseur","year":"1999","journal-title":"Am J Kidney Dis"},{"key":"2022030407592575500_sfaa276-B22","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.jaut.2017.12.014","article-title":"Autoantibodies against podocytic UCHL1 are associated with idiopathic nephrotic syndrome relapses and induce proteinuria in mice","volume":"89","author":"Jamin","year":"2018","journal-title":"J Autoimmun"},{"key":"2022030407592575500_sfaa276-B23","doi-asserted-by":"crossref","first-page":"332","DOI":"10.2215\/CJN.05000516","article-title":"Minimal change disease","volume":"12","author":"Vivarelli","year":"2017","journal-title":"Clin J Am Soc Nephrol"},{"key":"2022030407592575500_sfaa276-B24","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1007\/s00441-019-03147-y","article-title":"Idiopathic nephrotic syndrome and serum permeability factors: a molecular jigsaw puzzle","volume":"379","author":"Candelier","year":"2020","journal-title":"Cell Tissue Res"},{"key":"2022030407592575500_sfaa276-B25","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1016\/S0140-6736(74)91880-7","article-title":"Pathogenesis of lipoid nephrosis: a disorder of T-cell function","volume":"304","author":"Shalhoub","year":"1974","journal-title":"Lancet"},{"key":"2022030407592575500_sfaa276-B26","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.3892\/ol.2015.3325","article-title":"Alterations of immune cell subsets in relapsed, thymoma-associated minimal change disease: a case report","volume":"10","author":"Gharwan","year":"2015","journal-title":"Oncol Lett"},{"key":"2022030407592575500_sfaa276-B27","doi-asserted-by":"crossref","first-page":"2732","DOI":"10.1681\/ASN.2006121346","article-title":"A humanized mouse model of idiopathic nephrotic syndrome suggests a pathogenic role for immature cells","volume":"18","author":"Sellier-Leclerc","year":"2007","journal-title":"J Am Soc Nephrol"},{"key":"2022030407592575500_sfaa276-B28","doi-asserted-by":"crossref","first-page":"256ra136","DOI":"10.1126\/scitranslmed.3008538","article-title":"A circulating antibody panel for pretransplant prediction of FSGS recurrence after kidney transplantation","volume":"6","author":"Delville","year":"2014","journal-title":"Sci Transl Med"},{"key":"2022030407592575500_sfaa276-B29","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1093\/ndt\/gfm592","article-title":"Rapid remission of steroid and mycophenolate mofetil (MMF)-resistant minimal change nephrotic syndrome after rituximab therapy","volume":"23","author":"Yang","year":"2007","journal-title":"Nephrol Dial Transplant"},{"key":"2022030407592575500_sfaa276-B30","first-page":"281","article-title":"Megalin\/lipoprotein receptor-related protein 2 autoimmunity and kidney disease","volume":"13","author":"Perez-Gomez","year":"2020","journal-title":"Clin Kidney J"},{"key":"2022030407592575500_sfaa276-B31","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1093\/rheumatology\/39.9.1044","article-title":"Thymoma-associated systemic lupus erythematosus, exacerbating after thymectomy. A case report and review of the literature","volume":"39","author":"Boonen","year":"2000","journal-title":"Rheumatology (Oxford"},{"key":"2022030407592575500_sfaa276-B32","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1038\/2141134a0","article-title":"Antinuclear autoantibodies in Swiss mice thymectomized at birth","volume":"214","author":"Thivolet","year":"1967","journal-title":"Nature"},{"key":"2022030407592575500_sfaa276-B33","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.4049\/jimmunol.132.4.1809","article-title":"The effect of thymectomy on lupus-prone mice","volume":"132","author":"Hang","year":"1984","journal-title":"J Immunol"},{"key":"2022030407592575500_sfaa276-B34","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/S0344-0338(99)80002-8","article-title":"The role of T-cells in the initiation of autoantibody responses in thymoma patients","volume":"195","author":"Vincent","year":"1999","journal-title":"Pathol Res Pract"}],"container-title":["Clinical Kidney Journal"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ckj\/advance-article-pdf\/doi\/10.1093\/ckj\/sfaa276\/36250527\/sfaa276.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ckj\/article-pdf\/14\/9\/2090\/42687581\/sfaa276.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ckj\/article-pdf\/14\/9\/2090\/42687581\/sfaa276.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T00:20:42Z","timestamp":1697415642000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ckj\/article\/14\/9\/2090\/6078581"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,11]]},"references-count":34,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,1,11]]},"published-print":{"date-parts":[[2021,8,30]]}},"URL":"https:\/\/doi.org\/10.1093\/ckj\/sfaa276","relation":{},"ISSN":["2048-8513"],"issn-type":[{"value":"2048-8513","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,9,1]]},"published":{"date-parts":[[2021,1,11]]}}}