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Mercury Secondary Membranous Nephropathy — ESENeph MCQ

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ModerateGlomerulonephritisMercury Secondary Membranous NephropathyESENeph

A 30-year-old woman presents with nephrotic syndrome. She has been using skin-lightening cream containing mercury for 2 years. Kidney biopsy shows membranous nephropathy. What is the relationship?

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Correct answer: A — Mercury from skin-lightening creams causes secondary membranous nephropathy – the MN may improve or resolve after cessation of mercury exposure

Mercury is a well-recognised cause of secondary membranous nephropathy. Skin-lightening (skin-bleaching) creams, which are widely used in some communities, frequently contain inorganic mercury as an active ingredient. Chronic mercury exposure from these products can cause nephrotic syndrome from membranous nephropathy, as well as tubular toxicity. The MN is typically PLA2R-negative. Cessation of mercury exposure is the primary treatment, and the MN often improves or remits. Chelation therapy may be considered for high mercury levels.

Reference: KDIGO 2021 – GN (Secondary MN); Li et al 2010 – Mercury Nephropathy