Successful Treatment of Steroid-Resistant Minimal Change Disease with Mycophenolate Mofetil

2002 ◽  
Vol 22 (5-6) ◽  
pp. 569-572 ◽  
Author(s):  
András Mogyorósi ◽  
H. Robert Lippman ◽  
George M. Feldman
Keyword(s):  
Mycophenolate Mofetil ◽  
Successful Treatment ◽  
Minimal Change Disease ◽  
Minimal Change ◽  
Steroid Resistant

scholarly journals Steroid-resistant minimal change disease with ballooned podocytes

2017 ◽  
Vol 8 (2) ◽  
pp. 19-19
Author(s):  
Francesco Fortarezza ◽  
Maria Grazia Fiore ◽  
Michele Rossini ◽  
Domenico Piscitelli ◽  
Loreto Gesualdo ◽  
...  
Keyword(s):  
Minimal Change Disease ◽  
Minimal Change ◽  
Steroid Resistant

scholarly journals Respiratory Tract Infection: A Risk Factor for the Onset and Relapse of Adult-Onset Minimal Change Disease in Southern China

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Huanqin Han ◽  
Shujun Wang ◽  
Yanting Liang ◽  
Jieping Lin ◽  
Lei Shi ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Minimal Change Disease ◽  
Southern China ◽  
Minimal Change ◽  
Steroid Resistance ◽  
Adult Onset ◽  
Steroid Resistant ◽  
Frequent Relapse

Aims/Introduction. Steroid resistance and frequent relapse are problems in the treatment of minimal change disease (MCD). However, epidemiological factors that influence steroid-resistant and relapse of MCD are rarely reported. This study evaluated potential factors that influence the onset and relapse of MCD and the epidemiological features of southern Chinese patients with adult-onset MCD. Patients and Methods. Patients with adult-onset MCD were included from the Affiliated Hospital of Guangdong Medical University, which is located in the southernmost part of China’s mainland, between 2015 and 2016. Potential influencing factors were investigated. Results. Eighty-seven patients with incipient MCD were enrolled, and 85 of these patients were followed up; 71.8% (61/85) were steroid-sensitive and 28.2% (24/85) were steroid-resistant. In terms of seasonal distribution, the highest rate of incipient cases was in spring (39.1%, 34/87), which also showed a high rate of relapse cases (29.7%, 22/74). Among patients who were followed up for more than half a year and whose proteinuria completely resolved (69.4%, 59/85), 52.5% (31/59) were without relapse and 47.5% (28/59) were with relapse. Patients without relapse were older than those with relapse (P<0.05). Before disease onset, 20.7% (18/87) of patients with incipient MCD were diagnosed with infection, including 94.5% (17/18) with respiratory tract infection. Fourteen patients in complete remission posttreatment developed an infection before relapse, including 85.7% (12/14) with respiratory tract infection. Conclusion. Steroid resistance and frequent relapse are current challenges for the treatment of adult-onset MCD in southern China, and respiratory tract infection may be a risk factor for onset and relapse. Additionally, younger patients with MCD tend to have more frequent relapse.

scholarly journals CD80 and CTLA-4 as diagnostic and prognostic markers in adult-onset minimal change disease: a retrospective study

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e5400 ◽  
Author(s):  
Bing Zhao ◽  
Hui Han ◽  
Junhui Zhen ◽  
Xiaowei Yang ◽  
Jin Shang ◽  
...  
Keyword(s):  
Minimal Change Disease ◽  
Cytotoxic T Lymphocyte ◽  
Renal Tissue ◽  
Minimal Change ◽  
Diagnostic Methods ◽  
Adult Onset ◽  
Glucocorticoid Treatment ◽  
Steroid Resistant ◽  
Steroid Sensitive ◽  
Sensitive Marker

Background Minimal change disease (MCD) is a form of idiopathic nephrotic syndrome. Compared to children, adult-onset MCD patients are reported to have delayed responses to glucocorticoid treatment. Several studies of children have suggested detecting urinary CD80 levels to diagnose MCD. There are no effective diagnostic methods to distinguish steroid-sensitive MCD from steroid-resistant MCD unless treatments are used. Methods In a total of 55 patients with biopsy-proven MCD and 26 patients with biopsy-proven idiopathic membranous nephropathy, CD80 and cytotoxic T-lymphocyte antigen-4 (CTLA-4) levels in serum, urine and renal tissue were analyzed. Results Steroid-sensitive MCD patients in remission had lower urinary CD80 levels and higher CTLA-4 levels than patients in relapse (156.65 ± 24.62 vs 1066.40 ± 176.76 ng/g creatinine; p < 0.0001), (728.73 ± 89.93 vs 151.70 ± 27.01 ng/g creatinine; p < 0.0001). For MCD patients in relapse, mean urinary CD80 level was higher, and CTLA-4 level was lower for those who were steroid-sensitive than those who were steroid-resistant (1066.40 ± 176.76 vs. 203.78 ± 30.65 ng/g creatinine; p < 0.0001), but the mean urinary CTLA-4 level was lower (151.70 ± 27.01 vs. 457.83 ± 99.45 ng/g creatinine; p < 0.0001). CD80 expression in glomeruli was a sensitive marker to diagnose MCD. The absent or minimal expression of CTLA-4 in glomeruli could distinguish steroid-sensitive MCD from steroid-resistant MCD. Conclusions Glucocorticoid treatment may result in complete remission for only MCD patients with strongly positive CD80 expression and negative CTLA-4 expression in glomeruli, or higher urinary CD80 level and lower CTLA-4 level.

scholarly journals Intravenous cyclophosphamide induces remission in children with difficult to treat steroid resistant nephrotic syndrome from minimal change disease

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Maha Haddad ◽  
Arundhati Kale ◽  
Lavjay Butani
Keyword(s):  
Nephrotic Syndrome ◽  
North American ◽  
Minimal Change Disease ◽  
Immunosuppressive Agents ◽  
Laboratory Data ◽  
Minimal Change ◽  
Indian Children ◽  
Steroid Resistant ◽  
Steroid Resistant Nephrotic Syndrome ◽  
American Children

Abstract Background Steroid resistant nephrotic syndrome (SRNS), while uncommon in children, is associated with significant morbidity. Calcineurin inhibitors (CNIs) remain the first line recommended therapy for children with non-genetic forms of SRNS, but some children fail to respond to them. Intravenous (IV) cyclophosphamide (CTX) has been shown to be effective in Asian-Indian children with difficult to treat SRNS (SRNS-DTT). Our study evaluated the outcome of IV CTX treatment in North American children with SRNS-DTT. Methods Retrospective review of the medical records of children with SRNS-DTT treated with IV CTX from January 2000 to July 2019 at our center. Data abstracted included demographics, histopathology on renal biopsy, prior and concomitant use of other immunosuppressive agents and serial clinical/laboratory data. Primary outcome measure was attainment of complete remission (CR). Results Eight children with SRNS-DTT received monthly doses (median 6; range 4–6) of IV CTX. Four (50%) went into CR, 1 achieved partial remission and 3 did not respond. Three of the 4 responders had minimal change disease (MCD). Excluding the 1 child who responded after the 4th infusion, the median time to CR was 6.5 (range 0.5–8) months after completion of IV CTX infusions. Three remain in CR at a median of 8.5 years (range: 3.7–10.5 years) after completion of CTX; one child relapsed and became steroid-dependent. No infections or life-threatening complications related to IV CTX were observed. Conclusions IV CXT can induce long term remission in North-American children with MCD who have SRNS-DTT.

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