Successful Treatment of Nephrotic Syndrome Due to Collapsing Focal Segmental Glomerulosclerosis Accompanied by Acute Interstitial Nephritis |
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| Authors: | Hisato Shima Toshio Doi Takuya Okamoto Yusuke Higashiguchi Megumi Harada Tomoko Inoue Manabu Tashiro Seiichiro Wariishi Norimichi Takamatsu Kazuhiko Kawahara Kazuyoshi Okada Jun Minakuchi |
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| Affiliation: | 1.Department of Kidney Disease, Kawashima Hospital, Japan; 2.Department of Laboratory, Kawashima Hospital, Japan; 3.Department of Clinical Engineering Kawashima Hospital, Japan; 4.Department of Cardiovascular Surgery, Kawashima Hospital, Japan |
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| Abstract: | A 39-year-old woman was hospitalized for nephrotic syndrome. Laboratory test results showed increased serum creatinine levels and urinary excretions of beta-2-microglobulin, and N-acetyl-beta-D-glucosaminidase. A renal biopsy revealed collapsing focal segmental glomerulosclerosis (FSGS) and acute interstitial nephritis. Despite treatment with pulse steroid followed by oral high-dose glucocorticoids and cyclosporines, heavy proteinuria persisted. After low-density lipoprotein apheresis (LDL-A) therapy was initiated, her proteinuria gradually decreased, leading to complete remission. A repeat renal biopsy after treatment revealed no collapsing glomeruli. Immediate LDL-A should be performed to treat cases of collapsing FSGS poorly responding to other treatments. |
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| Keywords: | nephrotic syndrome collapsing focal segmental glomerulosclerosis steroid cyclosporin low-density lipoprotein apheresis |
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