Celiac disease associated membranous nephropathy - a rare cause or coincidence? A case report

INTRODUCTION: Celiac disease is associated with a variety of autoimmune diseases such as type 1 diabetes mellitus, autoimmune thyroid disorders, Sjogren's syndrome and IgA nephropathy, however membranous nephropathy is not recognized amongst one of them. CASE PRESENTATION: We report a rare case of nephrotic syndrome due to membranous nephropathy in a patient with celiac disease. A 77-years-old male patient presented with uncontrolled hypertension, anemia and acute renal failure. He was diagnosed with celiac disease and membranous nephropathy confirmed by small bowel and renal biopsy. Patient was treated with gluten free diet and immuno-suppressive therapy; however, he died within 2 to 3 months due to myocardial infarction. CONCLUSION: The association between celiac disease and nephrotic syndrome is extremely rare. Only two adult patients with celiac disease and membranous nephropathy have been reported in the literature so far. Since the prevalence of celiac disease ranges between 0.75% and 4.54%, the question arises whether the coexistence of celiac disease and membranous nephropathy is just a coincidence or a rare association. As they both are immune mediated diseases, a link between them is a strong possibility.