Document Detail


Nephrotic syndrome and idiopathic membranous nephropathy associated with autosomal-dominant polycystic kidney disease.
MedLine Citation:
PMID:  21552769     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
We report the case of a 38-year-old male with autosomal-dominant polycystic kidney disease (ADPKD) and concomitant nephrotic syndrome secondary to membranous nephropathy (MN). A 3-month course of prednisone 60 mg daily and losartan 100 mg daily resulted in resistance. Treatment with chlorambucil 0.2 mg/kg daily, low-dose prednisone, plus an angiotensin-converting enzyme inhibitor (ACEI) and an angiotensin II receptor blocker (ARB) for 6 weeks resulted in partial remission of his nephrotic syndrome for a duration of 10 months. After relapse of the nephrotic syndrome, a 13-month course of mycophenolate mofetil (MFM) 2 g daily and low-dose prednisone produced complete remission for 44 months. After a new relapse, a second 24-month course of MFM and low-dose prednisone produced partial to complete remission of proteinuria with preservation of renal function. Thirty-six months after MFM withdrawal, complete remission of nephrotic-range proteinuria was maintained and renal function was preserved. This case supports the idea that renal biopsy is needed for ADPKD patients with nephrotic-range proteinuria in order to exclude coexisting glomerular disease and for appropriate treatment/prevention of renal function deterioration. To the best of our knowledge, this is the first reported case of nephrotic syndrome due to MN in a patient with ADPKD treated with MFM, with remission of proteinuria and preservation of renal function after more than 10 years. Findings in this patient also suggest that MFM might reduce cystic cell proliferation and fibrosis, preventing progressive renal scarring with preservation of renal function.
Authors:
Ramon Peces; Jorge Martínez-Ara; Carlos Peces; Mariluz Picazo; Emilio Cuesta-López; Cristina Vega; Sebastián Azorín; Rafael Selgas
Related Documents :
22259649 - Improvement of venous leg ulcers with androgen replacement therapy in a patient with un...
21494529 - Mdct evaluation of cardiac involvement in hypereosinophilic syndrome: differentiating m...
21686439 - The enhanced s-cone syndrome in children.
21741809 - Devastating intracardiac and aortic thrombosis: a case report of apparent catastrophic ...
19825519 - Free circulating interleukin-18 is increased in schnitzler syndrome: a new autoinflamma...
19026279 - Modelling down syndrome.
3295719 - Forms of nephrotic syndrome more likely to progress to renal impairment.
2233519 - Superior vena cava syndrome associated with childhood malignancy: analysis of 24 cases.
3966449 - Small intestinal lymphoma in three patients with acquired immune deficiency syndrome.
Publication Detail:
Type:  Journal Article     Date:  2011-05-05
Journal Detail:
Title:  TheScientificWorldJournal     Volume:  11     ISSN:  1537-744X     ISO Abbreviation:  ScientificWorldJournal     Publication Date:  2011  
Date Detail:
Created Date:  2011-05-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101131163     Medline TA:  ScientificWorldJournal     Country:  England    
Other Details:
Languages:  eng     Pagination:  1041-7     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Right diaphragm spontaneous rupture: a surgical approach.
Next Document:  Perils and pitfalls regarding differential diagnosis and treatment of primary cutaneous anaplastic l...