Lipoic acid supplementation associated with neural epidermal growth factor-like 1 (NELL1)-associated membranous nephropathy.

Rebecca I Spain, Nicole K Andeen, Pamela C Gibson, Mary H Samuels, Cynthia D Morris, Andrew J Solomon, Richard Solomon, Carin Waslo, Rupali S Avasare

Journal: Kidney international 2021;100(6):1208-1213

PMID: 34662650

Abstract

Lipoic acid (alpha lipoic acid, thioctic acid) is a popular over-the-counter antioxidant and insulin-mimetic supplement under investigation in a variety of conditions including multiple sclerosis, diabetes, and schizophrenia. Unfortunately, high-grade proteinuria was an unexpected adverse event specific to the treatment arm of our clinical trial investigating lipoic acid supplementation in patients with multiple sclerosis. This observation led to detection of similar patients in our nephrology practice. Here, we describe four biopsy-proven cases of neural epidermal growth factor-like 1 (NELL1)-associated membranous nephropathy following lipoic acid supplementation and a fifth suspected case. Discontinuation of lipoic acid and supportive therapy resulted in remission.

Published by Elsevier Inc.

Address: Neurology Division, Portland VA Medical Center, Portland, Oregon, USA. Electronic address: [email protected].; Department of Pathology and Laboratory Medicine, Oregon Health & Science University, Portland, Oregon, USA.; Department of Pathology and Larboratory Medicine, The Robert Larner, M.D. College of Medicine at the University of Vermont, Burlington, Vermont, USA.; Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, Oregon, USA.; Department of Neurological Sciences, The Robert Larner, M.D. College of Medicine at the University of Vermont, Burlington, Vermont, USA.; Division of Nephrology and Hypertension, The Robert Larner, M.D. College of Medicine at the University of Vermont, Burlington, Vermont, USA.; Research Division, Portland VA Medical Center, Portland, Oregon, USA.; Department of Medicine, Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, USA.
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