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- Hisato Shima, Toshio Doi, Takuya Okamoto, Yusuke Higashiguchi, Megumi Harada, Tomoko Inoue, Manabu Tashiro, Seiichiro Wariishi, Norimichi Takamatsu, Kazuhiko Kawahara, Kazuyoshi Okada, and Jun Minakuchi.
- Department of Kidney Disease, Kawashima Hospital, Japan.
- Intern. Med. 2022 Jun 15; 61 (12): 1863-1867.
AbstractA 39-year-old woman was hospitalized for nephrotic syndrome. Laboratory test results showed increased serum creatinine levels and urinary excretions of beta-2-microglobulin, and N-acetyl-beta-D-glucosaminidase. A renal biopsy revealed collapsing focal segmental glomerulosclerosis (FSGS) and acute interstitial nephritis. Despite treatment with pulse steroid followed by oral high-dose glucocorticoids and cyclosporines, heavy proteinuria persisted. After low-density lipoprotein apheresis (LDL-A) therapy was initiated, her proteinuria gradually decreased, leading to complete remission. A repeat renal biopsy after treatment revealed no collapsing glomeruli. Immediate LDL-A should be performed to treat cases of collapsing FSGS poorly responding to other treatments.
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