A Patient with IgA Nephropathy: 5 Years after Complete Remission of Minimal Change Nephrotic Syndrome / 이화의대지

A 37-year-old male patient was admitted with generalized edema as the main symptom. A blood test confirmed hypoalbuminemia and hyperlipidemia, and a urine test confirmed severe albuminuria. A renal biopsy was conducted, which revealed a diagnosis of minimal change disease. Although the patient experienced complete remission of minimal change nephrotic syndrome after oral prednisolone and cyclophosphamide treatment, he is readmitted due to bilateral leg edema 5 years later since minimal change nephrotic syndrome was completely cured. The patient is diagnosed with IgA nephropathy. Although the exact mechanisms of IgA nephropathy in this patient remain unclear, this case represents an extremely rare development, and is separate from the remission of minimal change nephrotic syndrome.

Minimal Change Disease in Systemic Lupus: Another Renal Manifestation of Lupus? / 이화의대지

Nephrotic syndrome is most commonly observed in membranous lupus nephritis in patients with systemic lupus erythematosus (SLE). However, other forms of idiopathic nephrotic syndrome rarely occur in these patients. Here, we report a case of SLE complicated by minimal change disease (MCD). A 24-year-old woman with SLE visited our hospital for generalized edema and heavy proteinuria. Laboratory tests did not support immunological exacerbation of lupus, while renal biopsy revealed diffusely effaced foot processes without electron-dense deposits that were consistent with MCD. Administration of high-dose corticosteroids and 6 subsequent cycles of monthly intravenous cyclophosphamide resulted in complete remission. Although nephrotic-range proteinuria recurred 1 month after switching to maintenance therapy with mycophenolate mofetil, complete remission was reestablished after a 6-month treatment with corticosteroids and cyclosporine. Physicians should be cautious in assessment and management of such a rare renal manifestation.

A case of lupus podocytopathy manifesting with generalized edema and proteinuria / 대한내과학회지

A 20-year-old woman with systemic lupus erythematosus presented with generalized edema and nephrotic range proteinuria. A renal biopsy revealed diffuse foot process effacement without significant glomerular immune deposits, which was compatible with minimal-change nephrotic syndrome. The diagnosis of lupus podocytopathy was made and high-dose prednisolone was started. After prednisolone therapy, the generalized edema and proteinuria improved.