scholarly journals Complete Remission of Minimal Change Disease Following an Improvement of Lung Mycobacterium avium Infection

2016 ◽  
Vol 55 (18) ◽  
pp. 2669-2672 ◽  
Author(s):  
Aoi Yamashiro ◽  
Takahiro Uchida ◽  
Seigo Ito ◽  
Naoki Oshima ◽  
Takashi Oda ◽  
...  
Keyword(s):  
Complete Remission ◽  
Mycobacterium Avium ◽  
Minimal Change Disease ◽  
Minimal Change

scholarly journals Minimal change disease soon after Pfizer-BioNTech COVID-19 vaccination

2021 ◽  
Author(s):  
Seiji Kobayashi ◽  
Kazunori Fugo ◽  
Kazuto Yamazaki ◽  
Hiroyuki Terawaki
Keyword(s):  
Adverse Effect ◽  
Nephrotic Syndrome ◽  
Complete Remission ◽  
Messenger Rna ◽  
Minimal Change Disease ◽  
Kidney Biopsy ◽  
Minimal Change ◽  
Healthy Male ◽  
Intravenous Methylprednisolone ◽  
True Incidence

Abstract We report on the onset of minimal change disease (MCD) presenting with anasarca after a second dose of the messenger RNA (mRNA)-based Pfizer-BioNTech vaccine against coronavirus disease 2019 (COVID-19). A 75-year-old previously healthy male was admitted with rapidly progressive anasarca and proteinuria of 7.7 g/day following the second dose. A kidney biopsy revealed MCD with nephrotic syndrome. He was treated with intravenous methylprednisolone followed by prednisolone, leading to complete remission after 35 days in the hospital. Since definite causality between the vaccine and MCD remains unclear, awareness of this potential adverse effect of mRNA vaccines is important to determine its true incidence and frequency.

scholarly journals Minimal change disease associated with type 1 and type 2 diabetes mellitus

2012 ◽  
Vol 56 (5) ◽  
pp. 331-335 ◽  
Author(s):  
Miguel Moyses Neto ◽  
Gyl Eanes Barros Silva ◽  
Roberto S. Costa ◽  
Elen A. Romão ◽  
Osvaldo Merege Vieira Neto ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Complete Remission ◽  
Minimal Change Disease ◽  
Immunosuppressive Agents ◽  
Sudden Onset ◽  
Minimal Change ◽  
Diabetic Patients

A 19-year-old female with type 1 diabetes for four years, and a 73-year-old female with type 2 diabetes for twenty years developed sudden-onset nephrotic syndrome. Examination by light microscopy, immunofluorescence, and electron microscopy (in one case) identified minimal change disease (MCD) in both cases. There was a potential causative drug (meloxicam) for the 73-year-old patient. Both patients were treated with prednisone and responded with complete remission. The patient with type 1 diabetes showed complete remission without relapse, and the patient with type 2 diabetes had two relapses; complete remission was sustained after associated treatment with cyclophosphamide and prednisone. Both patients had two years of follow-up evaluation after remission. We discuss the outcomes of both patients and emphasize the role of kidney biopsy in diabetic patients with an atypical proteinuric clinical course, because patients with MCD clearly respond to corticotherapy alone or in conjunction with other immunosuppressive agents.

scholarly journals Extended infusion of rituximab combined with steroids is effective in inducing remission and reducing relapse in adult minimal change disease

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Diankun Liu ◽  
Zhanmei Zhou ◽  
Mengyi Wang ◽  
Sheng Nie ◽  
Jun Li ◽  
...  
Keyword(s):  
Complete Remission ◽  
Adverse Events ◽  
Relapse Rate ◽  
Minimal Change Disease ◽  
Remission Rate ◽  
Optimal Dose ◽  
Biological Data ◽  
Minimal Change ◽  
Before And After

Abstract Background Minimal change disease is a common cause of nephrotic syndrome in adults. Higher relapse rate put patients at risk of steroids toxicity due to long-term exposure. Rituximab has been suggested to maintain long time remission and withdraw steroids and other immunosuppressants with fewer adverse events. However, optimal dose and dosing interval have not been explored. Methods Twenty-five patients were enrolled from 2017-10 to 2020-03 in Nanfang Hospital in China. Clinical and biological data were extracted from medical records and laboratory databases. Therapy composed of 375mg/m2 rituximab once three weeks for 3 dose and corticosteroid was applied. Complete remission was defined as reduction of proteinuria to 0.3g/d. Remission rate, relapse rate, steroids used before and after rituximab therapy and adverse effects were documented at a mean time of 14.71 months. Results Twenty-two patients achieved complete remission for an average of 3.26 months and only 3 patients experienced one relapse respectively during the follow-up period. The mean remission maintenance time was 11.6 months, and was 5 months after steroids withdrawal. Steroids dose at last follow-up was 6.09mg/d, which was significantly reduced compared to 28.15mg/d before rituximab. Relapse rate before and after rituximab was 1.43 and 0.1, respectively. Only four minor adverse events were recorded. Conclusions Therapy consisted of 375mg/m2 rituximab once three weeks for 3 dose combined with corticosteroid is effective in inducing remission in adult patients with minimal change disease. Both of the relapse rate and dose of steroids used are significantly decreased with fewer side effects.

scholarly journals Randomized, Controlled Trial of Tacrolimus and Prednisolone Monotherapy for Adults with De Novo Minimal Change Disease

2020 ◽  
Vol 15 (2) ◽  
pp. 209-218 ◽  
Author(s):  
Nicholas Rhys Medjeral-Thomas ◽  
Christopher Lawrence ◽  
Marie Condon ◽  
Bhrigu Sood ◽  
Paul Warwicker ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Nephrotic Syndrome ◽  
Complete Remission ◽  
Minimal Change Disease ◽  
De Novo ◽  
Controlled Trial ◽  
Minimal Change ◽  
Randomized Controlled ◽  
Remission Rates ◽  
Relapse Rates

Background and objectivesMinimal change disease is an important cause of nephrotic syndrome in adults. Corticosteroids are first-line therapy for minimal change disease, but a prolonged course of treatment is often required and relapse rates are high. Patients with minimal change disease are therefore often exposed to high cumulative corticosteroid doses and are at risk of associated adverse effects. This study investigated whether tacrolimus monotherapy without corticosteroids would be effective for the treatment of de novo minimal change disease.Design, setting, participants, & measurementsThis was a multicenter, prospective, open-label, randomized, controlled trial involving six nephrology units across the United Kingdom. Adult patients with first presentation of minimal change disease and nephrotic syndrome were randomized to treatment with either oral tacrolimus at 0.05 mg/kg twice daily, or prednisolone at 1 mg/kg daily up to 60 mg daily. The primary outcome was complete remission of nephrotic syndrome after 8 weeks of therapy. Secondary outcomes included remission of nephrotic syndrome at 16 and 26 weeks, rates of relapse of nephrotic syndrome, and changes from baseline kidney function.ResultsThere were no significant differences between the tacrolimus and prednisolone treatment cohorts in the proportion of patients in complete remission at 8 weeks (21 out of 25 [84%] for prednisolone and 17 out of 25 [68%] for tacrolimus cohorts; P=0.32; difference in remission rates was 16%; 95% confidence interval [95% CI], −11% to 40%), 16 weeks (23 out of 25 [92%] for prednisolone and 19 out of 25 [76%] for tacrolimus cohorts; P=0.25; difference in remission rates was 16%; 95% CI, −8% to 38%), or 26 weeks (23 out of 25 [92%] for prednisolone and 22 out of 25 [88%] for tacrolimus cohorts; P=0.99; difference in remission rates was 4%; 95% CI, −17% to 25%). There was no significant difference in relapse rates (17 out of 23 [74%] for prednisolone and 16 out of 22 [73%] for tacrolimus cohorts) for patients in each group who achieved complete remission (P=0.99) or in the time from complete remission to relapse.ConclusionsTacrolimus monotherapy can be effective alternative treatment for patients wishing to avoid steroid therapy for minimal change disease.PodcastThis article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2020_01_16_CJN06180519.mp3

scholarly journals De Novo Minimal Change Disease following Vaccination with the Pfizer/BioNTech SARS-CoV-2 Vaccine in a Living Kidney Donor

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 37
Author(s):  
Smaragdi Marinaki ◽  
Kyriaki Kolovou ◽  
George Liapis ◽  
Chrysanthi Skalioti ◽  
Stathis Tsiakas ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Complete Remission ◽  
Minimal Change Disease ◽  
De Novo ◽  
Vaccine Dose ◽  
Oral Prednisolone ◽  
Minimal Change ◽  
Kidney Donor ◽  
Living Kidney Donor ◽  
Glomerular Diseases

Coronavirus disease 2019 has developed as a pandemic. Immunization with the introduction of vaccines against COVID-19 seems be the only way to end this pandemic. We report on a case of a kidney donor, who developed minimal change disease (MCD) within 4 days post-vaccination with the SARS-CoV-2 BNT162b2 mRNA vaccine (Pfizer/BioNTech). She donated her kidney to her husband 4 years ago. After receiving the 1st vaccine dose, she presented with nephrotic syndrome, with complete remission 5 days later. She proceeded with the second dose of the BNT162b2 vaccine at the appointed time. Two days later, she presented with a relapse of full-blown nephrotic syndrome with preserved renal function. We performed an ultrasound-guided percutaneous kidney biopsy and the final diagnosis was consistent with minimal change disease. Oral prednisolone was promptly initiated at a dosage of 1 mg/kg daily and complete remission was achieved 10 days later. More data about this rare appearance of de novo glomerular diseases after SARS-CoV-2 vaccination are emerging and should be interpreted rigorously.

scholarly journals Adult-onset nephrotic syndrome following COVID-19 vaccination

2021 ◽  
Author(s):  
Vivek Biradar ◽  
Abhijit Konnur ◽  
Sishir Gang ◽  
Umapati Hegde ◽  
Mohan Rajapurkar ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Complete Remission ◽  
Minimal Change Disease ◽  
Kidney Biopsy ◽  
Oral Prednisolone ◽  
Minimal Change ◽  
Adult Onset ◽  
Healthy Man

Abstract A 22-year-old healthy man was admitted for edema 15 days after the first injection of the COVISHIELD COVID-19 vaccine (Oxford AstraZeneca) vaccine. Nephrotic syndrome was diagnosed and a kidney biopsy showed minimal change disease. Oral Prednisolone was started at 1mg/kg/day resulting in complete remission within one week.

scholarly journals Rituximab Induces Complete Remission of Proteinuria in a Patient With Minimal Change Disease and No Detectable B Cells

2021 ◽  
Vol 11 ◽  
Author(s):  
Maximilian Webendörfer ◽  
Linda Reinhard ◽  
Rolf A. K. Stahl ◽  
Thorsten Wiech ◽  
Hans-Willi Mittrücker ◽  
...  
Keyword(s):  
T Cells ◽  
Nephrotic Syndrome ◽  
B Cells ◽  
Complete Remission ◽  
Treatment Efficacy ◽  
Minimal Change Disease ◽  
Predictive Biomarkers ◽  
Minimal Change ◽  
Frequent Relapses ◽  
Steroid Sensitive Nephrotic Syndrome

Minimal change disease (MCD) is a common cause of nephrotic syndrome. Treatment with steroids is usually effective, but frequent relapses are therapeutic challenges. The anti-CD20 antibody rituximab has shown promising results for treatment of steroid-sensitive nephrotic syndrome. Since predictive biomarkers for treatment efficacy and the accurate rituximab dosage for effective induction of remission are unknown, measurement of CD19+ B cells in blood is often used as marker of successful B cell depletion and treatment efficacy. A male patient with relapsing MCD was successfully treated with rituximab, but developed relapse of proteinuria 1 year later, although no B cells were detectable in his blood. B and T cell populations in the patient’s blood were analyzed before and after treatment with rituximab using FACS analysis. Rituximab binding to B and T cells were measured using Alexa Fluor 647 conjugated rituximab. We identified a population of CD20+ CD19− cells in the patient’s blood, which consisted mostly of CD20+ CD3+ T cells. Despite the absence of B cells in the blood, the patient was again treated with rituximab. He developed complete remission of proteinuria and depletion of CD20+ T cells. In a control patient with relapsing MCD initial treatment with rituximab led to depletion of both CD20+ B and T cells. Rituximab induces remission of proteinuria in patients with MCD even if circulating B cells are absent. CD20+ T cells may play a role in the pathogenesis of MCD and might be a promising treatment target in patients with MCD.

MO289IS THERE A ROLE OF INTERSTITIAL CHANGES ON THERAPY OUTCOME AMONG PATIENTS WITH FOCAL-SEGMENTAL GLOMERULAR SCLEROSIS AND MINIMAL CHANGE DISEASE?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Aleksandar Jankovic ◽  
Petar Djuric ◽  
Ana Bulatovic ◽  
Dragana Markovic ◽  
Snezana Pešić ◽  
...  
Keyword(s):  
Complete Remission ◽  
Partial Remission ◽  
Minimal Change Disease ◽  
Minimal Change ◽  
Therapy Outcome ◽  
Glomerular Sclerosis ◽  
First Line Therapy ◽  
Focal Segmental Glomerular Sclerosis ◽  
Significant Difference ◽  
Immunosuppressive Protocol

Abstract Background and Aims It is well-known that interstitial changes in patients with focal-segmental glomerulosclerosis (FSGS) and minimal change disease (MCD) are linked with disease chronicity and progression. The aim of this study was to analyze is there any connection between interstitial changes and outcome after “first line” therapy in patients with FSGS/MCD. Method From 2014 till 2019, biopsy proven diagnosis of FSGS/MCD was established in 40 patients. Interstitial changes were classified in three groups as following: 0-w/o changes; 1-mild changes; 2-severe changes. Patients with nephrotic syndrome (No=29) were treated with prednisolone (1mg/kg) and after six months we have registered therapy outcome as: CR-complete remission; PR-partial remission; EX-death; NO-no effect. Results Among treated patients (age 50.4±15.3 years, 15 men), CR was achieved in 10 patients (34.5%) and 6 out of these 10 (60%) had no interstitial changes. Partial remission was observed in 11 patients (37.9%), in 4 patients (13.8%) therapy did not have any effect, and 4 patients (13.8%) deceased (table 1). All patients in EX and NO group had interstitial changes. There were no significant difference in age, gender, proteinuria, albuminaemia, creatinine and glycaemia levels between groups except for hemoglobin levels that were significantly lower in EX group than in others (∑ 15.144; p=0.002) and urea levels that were significantly higher in EX group (∑ 138.057; p=0.024). Conclusion Patients with FSGS/MCD respond well on standard immunosuppressive protocol, particularly in absence of interstitial changes what may increase the chance for achieving complete remission.

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