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.

硫辛酸（α 硫辛酸，硫辛酸）是一种流行的非处方抗氧化剂和胰岛素模拟补充剂，正在研究多种疾病，包括多发性硬化症、糖尿病和精神分裂症。不幸的是，高级别蛋白尿是我们在多发性硬化症患者中调查硫辛酸补充剂的临床试验治疗组特有的意外不良事件。这一观察导致我们在肾脏病学实践中发现了类似的患者。在这里，我们描述了四例经活检证实的神经表皮生长因子样 1 (NELL1) 相关膜性肾病在补充硫辛酸后的病例和第五例疑似病例。停用硫辛酸和支持疗法导致病情缓解。