ORIGINAL ARTICLE Coexistent findings of renal glomerular disease with Hashimoto’s thyroiditis Gu ¨ lay Koc ¸ ak, Bu ¨ lent Huddam, Alper Azak, Levent Ortabozkoyun and Murat Duranay Department of Nephrology, Ankara Education and Research Hospital, Ankara, Turkey Summary Aim and Background Hashimoto’s thyroiditis (HT) is a com- mon autoimmune thyroid disease with a female preponderance. Renal involvement in HT is not uncommon. In the present study, we aimed to define the frequency and characteristics of the glomer- ular diseases associated with HT and further the understanding of any common pathogenesis between HT and glomerular disease. Materials and Methods We reviewed retrospectively 28 patients with HT who were referred to our Department because of unex- plained haematuria, proteinuria or renal impairment from 2007 to 2011. Routine laboratory investigations including blood count, serum biochemistry, urinalysis and 24-h urinary protein excretion were performed on all patients. Renal biopsy was performed in 20 patients with HT, and the specimens were examined by light microscopy and immunofluorescence staining. Results We detected four cases of focal segmental glomeruloscle- rosis (FSGS), four membranous glomerulonephritis (MGN), two minimal-change disease (MCD), three immunoglobulin A nephri- tis (IgAN), three chronic glomerulonephritis (CGN) and one amy- loidosis. In three patients, the renal biopsy findings were nonspecific. Daily urinary protein excretion and glomerular filtra- tion rates were found to be independent of the level of thyroid hor- mone and thyroid-specific autoantibodies. Conclusion Glomerular pathologies associated with HT are simi- lar to those in the general population, the most common lesions being MGN, FSGS and IgA nephritis. (Received 11 August 2011; returned for revision 31 August 2011; finally revised 2 November 2011; accepted 18 November 2011) Introduction Autoimmune thyroiditis (AT) is the most common organ-specific autoimmune disorder, affecting approximately 2% of the female population and 0.2% of the male population. 1 Two types of AT are causes of persistent hypothyroidism: Hashimoto’s thyroiditis (HT) (goitrous form) and atrophic thyroiditis (nongoitrous form). 2 HT arises owing to complex interactions between environmental and genetic factors that are yet to be completely defined. An association between glomerulonephritis and HT has been described, mainly in cases of membranous nephropathy and membranoproliferative glomerulonephritis (MPGN), 3,4 but there are only a few reported cases in the literature. In the present study, we aimed to define the frequency and characteristics of the glomerular type of renal dis- eases associated with HT. Materials and methods The study was approved by the local ethics committee and con- ducted in accordance with the ethical principles described by the Declaration of Helsinki. The specific diagnosis of HT was made by an endocrinologist based on routine thyroid function tests, thyroid antibody measurement and thyroid scan. The patients with HT, who were referred to our department because of unexplained haematuria, proteinuria or renal impairment from 2007 to 2011, were retrospectively reviewed. Patients with concomitant diseases such as a history of urinary stones, sys- temic vasculitis, connective tissue disease or diabetes mellitus were excluded from the study. Routine laboratory investigations including full blood count, serum biochemistry, urinalysis and 24-h urinary protein excretion were performed on all patients. Renal biopsy was not performed in eight patients because of regression of proteinuria and improvement in renal function during follow-up. Renal biopsy was performed in twenty patients with HT, and the specimens were examined by light microscopy and immunofluorescence staining. All statistical analyses were performed using the spss for Windows, version 15 (Chicago, IL, USA). Results are expressed as means ± stan- dard deviation, and statistical significance was accepted as P < 0.05. Results Twenty-eight patients (10 men and 18 women; mean age, 45.6 ± 16.7) with HT were included in the study. Some of the fea- tures of the patients are presented in Table 1. In 12 patients (43%), the estimated glomerular filtration rates (GFR) (according to Correspondence: Gulay Kocak, Keklikpınarı mahallesi, 240 sokak, Duru apartmanı, 8/6, Dikmen, C ¸ ankaya, Ankara, Turkey. Tel.: +90 312 4768147; E-mail: gulaykad@hotmail.com Clinical Endocrinology (2012) 76, 759–762 doi: 10.1111/j.1365-2265.2011.04302.x Ó 2012 Blackwell Publishing Ltd 759