scholarly journals Disseminated Strongyloidiasis in Association with Nephrotic Syndrome

2018 ◽  
Vol 8 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Amirahwaty Abdullah ◽  
Lydia Winnicka ◽  
Charumathi Raghu ◽  
Violeta Zeykan ◽  
Jagmeet Singh
Keyword(s):  
Nephrotic Syndrome ◽  
Causal Relationship ◽  
Parasitic Infection ◽  
Minimal Change Nephrotic Syndrome ◽  
Minimal Change ◽  
High Dose ◽  
The World ◽  
Disseminated Strongyloidiasis

Strongyloidiasis is a well-known parasitic infection endemic in tropical and subtropical areas of the world. While most infected individuals are asymptomatic, strongyloidiasis-related glomerulopathy has not been well documented. We present a case of disseminated strongyloidiasis in a patient with minimal change nephrotic syndrome treated with high-dose corticosteroids. The remission of nephrotic syndrome after treatment of strongyloidiasis suggests a possible causal relationship between Strongyloides and nephrotic syndrome.

scholarly journals A Case of Frequently Relapsing Minimal-Change Nephrotic Syndrome with Steroid-Induced Psychiatric Syndrome Treated by Low-Dose, Short-Term Steroid Therapy in Combination with Cyclosporine

2020 ◽  
Vol 10 (1) ◽  
pp. 1-8
Author(s):  
Isao Kondo ◽  
Yohei Arai ◽  
Akiyoshi Hamada ◽  
Kota Yamada ◽  
Shingo Shioji ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Steroid Therapy ◽  
Clinical Remission ◽  
Low Dose ◽  
Initial Dosage ◽  
Minimal Change Nephrotic Syndrome ◽  
Minimal Change ◽  
High Dose ◽  
Short Term ◽  
Psychiatric Syndrome

Adults with minimal-change nephrotic syndrome (MCNS) generally receive oral prednisolone (PSL) at an initial dosage of 1.0 mg/kg/day for a minimum of 4 weeks, with 80% of patients achieving clinical remission. However, relapses are frequent, necessitating repeated treatment with high-dose PSL. Long-term treatment with high-dose steroids increases the risk of steroid toxicities, such as diabetes mellitus, gastric complications, infections, osteoporosis, and steroid-induced psychiatric syndrome (SIPS), which may compromise the patient’s quality of life. Strategies are therefore needed to reduce the dosage and duration of steroid therapy for frequently relapsing MCNS (FRNS). Here, we suggest a new combination therapy of low-dose and short-term steroid with cyclosporine (CsA). We encountered an adult patient who developed recurrence of FRNS with depression arising from SIPS and was treated using low-dose, short-term PSL combined with CsA. He was successfully treated with PSL at an initial dosage of 0.3 mg/kg/day (20 mg/day) for just 2 weeks combined with CsA, allowing earlier induction of complete remission. We then promptly reduced the dose of PSL to below a physiological dosage (5 mg/day) over 3 weeks without relapse after episodes of SIPS and quickly resolved psychiatric symptoms. CsA in combination with PSL can reduce the initial dosage of PSL, shorten the time to remission, and easily maintain clinical remission. This protocol appears clinically useful and potentially applicable as a future treatment strategy for FRNS troubled by SIPS.

scholarly journals Comparison of the Efficacy and Safety of Tacrolimus and Low-Dose Corticosteroid with High-Dose Corticosteroid for Minimal Change Nephrotic Syndrome in Adults

2020 ◽  
Vol 32 (1) ◽  
pp. 199-210
Author(s):  
Ho Jun Chin ◽  
Dong-Wan Chae ◽  
Yong Chul Kim ◽  
Won Suk An ◽  
ChunGyoo Ihm ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Complete Remission ◽  
Low Dose ◽  
Study Drug ◽  
Minimal Change Nephrotic Syndrome ◽  
Minimal Change ◽  
High Dose ◽  
Once Daily ◽  
High Dose Steroid ◽  
Dose Corticosteroid

BackgroundTacrolimus is used as a steroid-sparing immunosuppressant in adults with minimal change nephrotic syndrome. However, combined treatment with tacrolimus and low-dose steroid has not been compared with high-dose steroid for induction of clinical remission in a large-scale randomized study.MethodsIn this 24-week open-label noninferiority study, we randomized 144 adults with minimal change nephrotic syndrome to receive 0.05 mg/kg twice-daily tacrolimus plus once-daily 0.5 mg/kg prednisolone, or once-daily 1 mg/kg prednisolone alone, for up to 8 weeks or until achieving complete remission. Two weeks after complete remission, we tapered the steroid to a maintenance dose of 5–7.5 mg/d in both groups until 24 weeks after study drug initiation. The primary end point was complete remission within 8 weeks (urine protein: creatinine ratio <0.2 g/g). Secondary end points included time until remission and relapse rates (proteinuria and urine protein: creatinine ratio >3.0 g/g) after complete remission to within 24 weeks of study drug initiation.ResultsComplete remission within 8 weeks occurred in 53 of 67 patients (79.1%) receiving tacrolimus and low-dose steroid and 53 of 69 patients (76.8%) receiving high-dose steroid; this difference demonstrated noninferiority, with an upper confidence limit below the predefined threshold (20%) in both intent-to-treat (11.6%) and per-protocol (17.0%) analyses. Groups did not significantly differ in time until remission. Significantly fewer patients relapsed on maintenance tacrolimus (3–8 ng/ml) plus tapered steroid versus tapered steroid alone (5.7% versus 22.6%, respectively; P=0.01). There were no clinically relevant safety differences.ConclusionsCombined tacrolimus and low-dose steroid was noninferior to high-dose steroid for complete remission induction in adults with minimal change nephrotic syndrome. Relapse rates were significantly lower with maintenance tacrolimus and steroid compared with steroid alone. No clinically-relevant differences in safety findings were observed.

scholarly journals The beneficial effects of plasma exchange for treatment of acute kidney injury in minimal change nephrotic syndrome

2011 ◽  
Vol 45 (2) ◽  
pp. 179-185
Author(s):  
Hideyo Oguchi ◽  
Marohito Murakami ◽  
Takashi Araki ◽  
Mariko Meguro ◽  
Akinori Hashiguchi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Nephrotic Syndrome ◽  
Plasma Exchange ◽  
Kidney Injury ◽  
Minimal Change Nephrotic Syndrome ◽  
Minimal Change ◽  
Beneficial Effects

scholarly journals Effect of single-dose rituximab on steroid-dependent minimal-change nephrotic syndrome in adults

2012 ◽  
Vol 28 (5) ◽  
pp. 1225-1232 ◽  
Author(s):  
T. Takei ◽  
M. Itabashi ◽  
T. Moriyama ◽  
C. Kojima ◽  
S. Shiohira ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Single Dose ◽  
Minimal Change Nephrotic Syndrome ◽  
Minimal Change ◽  
Steroid Dependent

LONG-TERM OUTCOME FOR CHILDREN WITH MINIMAL-CHANGE NEPHROTIC SYNDROME

The Lancet ◽  
1985 ◽  
Vol 325 (8425) ◽  
pp. 368-370 ◽  
Author(s):  
R.S. Trompeter ◽  
J. Hicks ◽  
B.W. Lloyd ◽  
R.H.R. White ◽  
J.S. Cameron
Keyword(s):  
Nephrotic Syndrome ◽  
Minimal Change Nephrotic Syndrome ◽  
Minimal Change ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Role of ‘catalytic’ iron in an animal model of minimal change nephrotic syndrome

1996 ◽  
Vol 49 (2) ◽  
pp. 370-373 ◽  
Author(s):  
Norishi Ueda ◽  
Radhakrishna Baliga ◽  
Sudhir V. Shah
Keyword(s):  
Animal Model ◽  
Nephrotic Syndrome ◽  
Minimal Change Nephrotic Syndrome ◽  
Minimal Change
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