Bacterial infection possibly causing autoimmunity: Tropheryma whipplei and membranous nephropathy

A 45-year-old man presented to our department with a 5-month history of foamy urine and swollen legs. Previously, the patient had epilepsy, seronegative rheumatoid arthritis, and thyroid carcinoma. He was being prescribed the following medications: carbamazepine, levothyroxine, ezetimibe combined with simvastatin, calcitriol, ramipril, furosemide, and mesoglycan. On examination, the patient had moderate oedema of both lower limbs with no other atypical findings; his blood pressure was 140/85 mm Hg and heart rate was 76 beats per min.