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Kidney Week

Abstract: TH-PO673

Nonsteroidal Anti-inflammatory Drugs (NSAIDs) Associated with NELL1-Positive Membranous Glomerulopathy

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Thimmisetty, Ravi K., University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States
  • Carias Martinez, Karla G., University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States
  • Vasquez-Rios, George, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States
Introduction

Membranous nephropathy (MN) is the leading cause of nephrotic syndrome in adults. We are presenting a rare case of neural epidermal growth factor-like 1 (NELL-1) caused by NSAIDs.

Case Description

A 49-year-old male with history of hyperlipidemia, DJD and on chronic NSAIDs admitted with complaints of periorbital swelling and generalized body swelling since 2 weeks. Also weight gain of 10 pounds over the last few weeks. h/o recent URI symptoms that resolved quickly. he is taking meloxicam for chronic foot pain and also started taking Artri King for last 2 weeks. vitals were with in acceptable range. on room air. exam shows 1-2+ edema.
Labs showed serum Cr of 1.68, nephrotic range proteinuria with random UP/UC ratio 9.52, COVID-19 positive. rest of the labs were acceptable.
Biopsy showed Membranous Glomerulopathy, NELL1-Positive.
With supportive care, creatinine was 1.05 mg/dl and up/uc is 0.06.

Discussion

NELL1-associated MN is commonly described with malignancy. Our case showed that NSAIDs also contribute for this target antigen associated MN. With in 1-2 months, patient better significantly with supportive care. There is an FDA alert on this Over the counter drug. Need to educate all providers in community not to use Artri King.

Ig G1-2 +