Document Type : Original Research Article


1 Assistant Professor, Department of Internal Medicine, Lorestan University of Medical ‎Sciences, Khorramabad, Iran

2 MD, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran


Different glomerular diseases are associated with various neoplasms. It seems obvious that ‎Carcinoma of Unknown Primary (CUP) induced nephrotic syndrome is rare. In this regard, the ‎present article introduces a patient suffering from nephrotic syndrome associated with CUP. ‎Patient is a 65-year-old non-smoker male who referred to the clinic for one-month generalized ‎edema. The patient was also complaining from coughing and bulky yellowish sputum with no ‎signs of blood. Patient's chest radiography revealed pulmonary pleural effusion of the left lung, ‎but no other pathological findings were revealed. Patient's cytology report of pleural fluid ‎indicated metastatic carcinoma, and therefore, the patient needed additional examinations so that ‎the origin of metastases (lung, gastrointestinal tract, pancreas, etc.) could be detected. Finally, ‎chemotherapy treatments began when the patient was diagnosed with Carcinoma of Unknown ‎Primary (CUP). With the continuation of chemotherapy treatment and follow-up after more than ‎a year of treatment, the patient is now generally well-off; his nephrotic syndrome has also been in ‎remission parallel to chemotherapy. Significant point in the treatment of this patient is ‎proteinuria, hypercholesterolemia and ‎ hyponatremia remission in two stages of chemotherapy. ‎These findings suggest probable para-neoplastic nephrotic syndrome.‎ The treatment of paraneoplastic is the treatment of underlying cause.

Graphical Abstract

Nephrotic syndrome associated with carcinoma of unknown primary ‎treated with chemotherapy: A rare case report


[1] P.M. Ronco, Kidney Int., ‎‎1999, 56, 355–377.‎
[2] J. Galloway, Br. Med. J., 1922, 23, 1201–1204.
‎[3] ‎J. Bacchetta, L. Juillard, P. Cochat, J.P. Droz, Critical Reviews in Oncology/Hematology, 2009, 70, 39-58.
‎[4] ‎F. Tourneur, R. Bouvier, J, Langue, M.H. Saϊd, C. Bergeron, M. Hermier, P. Cochat, Pediatr. Nephrol., 2000, 14, 53–55‎.
‎[5] (a) S.R. Orth, E. Ritz, N. Engl. J. Med., 1998, 338, 1202–1211. (b) R. Jamili Oskouei, N. Moradi-Kor, S. Abbasi Maleki, Am. J. Cancer. Res., 2017, 7: 610-627.
‎[6] K.D. Jhaveri, H.H. Shah, K. Calderon, E.S. Campenot, J. Radhakrishnan, Kidney Int., 2013, 84, 34-44.
‎[7] T. Soleymanian, G. Hamid, M. Arefi, I. Najafi, M.R. Ganji, M. Amini, M. Hakemi, M.R. Tehrani, B. Larijani, Renal failure, 2015, 37, 572-575‎‏.‏
‎‎[8] A.M. Davison, Nephrol. Dial. Transplant, 2001, ‎‎16, 13–14.‏
‎‎[9] V. Audard, F. Larousserie, P. Grimbert, M. Abtahi, J.J. Sotto, A. Delmer, F. Boue, D. Nochy, N. Brousse, R. Delaru, P. Remy, P. Ronco, D. Sahali, P. Lang, O. Hermine, Kidney Int., ‎‎2006, 69, 2251–2260‎.‏
‎‎[10] J.C. Lee, H. Yamauchi, J.J. Hopper, ‎Ann. Intern. Med., 1966, 64, 41–51.‏
‎‎[11] (a) Y.H. Lien, L.W. Lai, Nat. Rev. Nephrol., 2011, 7, 85–95. (b) P. Saraei, I. Asadi, M.A. Kakar, N. Moradi-Kor, Cancer. Manag. Res., 2019, 11, 3295-3313.
‎‎[12] J.L. Abbruzzese, R. Lenzi, M.N. Raber, S. Pathac, P. Frost, Semin. Oncol., 1993, 20, 238–243‎.
‎‎[13] R. Bugat, A. Bataillard, T. Lesimple, J.J. Voigt, S. Culine, A. Lortholary, Y. Merrouche, G. Ganem, M.C. Kaminsky, S. Negrier, M. Perol, C. Laforet, P. Bedossa, G. Bertrand, J.M. Coindre, K. Fizazi, Br. J. Cancer, 2003, 89, S59–S66‎.
‎‎[14] G.R. Varadhachary, Gastrointestinal Cancer Research, 2007, 1, 229-235‎.
[15] K. Ghanadi, H. Mahmoudvand,  Al. Bakhtiari, M. Gorji,  N. Moradi-kor, M.J. Tarahi, M. Garmsiri, Z. Obeidavi, Biomol Concepts, 2019, 10, 68-72.
‎‎[16] W.H. Coltharp, S.M. Lee, R.F. Miller, M.S. Averbuch, Ann. Thorac. Surg., 1991, 51, 308-309‎.
‎‎[17] (a) S.G. Pauker, R.I. Kopelman, N. Engl. J. Med., 1993, 328, 1621-1624‎. (b) M. Karimi Goftar, N. Moradi-Kor, Z. Moradi Kor, Int. J. Adv. Biol. Biom. Res., 2014, 2, 811-822.
‎‎[18] F.C. Lin, J.Y. Chen, A.H. Yang, S.C. Chang, Am. J. Med. Sci., 2002, 324, 161-165.
‎‎[19] S. Miyajima, Y. Taguchi, E. Tanaka, T. Inoue, M. Sakuramoto, M. Minakuchi, Y. Maeda, K. Maniwa, K. Tanizawa, M. Okamoto, T. Takeda, Nihon Kokyuki Gakkai Zasshi, 2006, 44, 631-635.