Cyclosporin A-sensitive nephrotic syndrome preceding Hodgkin's disease by 32 months.
A 20-year-old man developed a massive nephrotic syndrome, rapidly complicated by pulmonary embolism and septicemia. Two renal biopsies taken 3 months apart showed minimal change glomerulonephritis. Treatment with prednisolone 1.5 mg/kg/day failed to induce a sustained remission, then monotherapy with cyclosporin A (CsA, 5 mg/kg/day) was started. Complete remission was obtained after 15 weeks. CsA was gradually tapered to 3 mg/kg/day. Twenty-two months after starting CsA, a routine examination disclosed a right sub-clavicular lymph node, of which histological examination showed a class 4 large cell Hodgkin's lymphoma. CsA was abruptly withdrawn and a polychemotherapy resulted in lymphoma remission after four courses. Ten months later, Hodgkin's disease is currently in remission and there is no relapse of proteinuria.
Fouque
D
D
Clinique de Néphrologie, Université Claude-Bernard Lyon I, France.
Laville
M
M
Colon
S
S
French
M
M
Berger
F
F
Labeeuw
M
M
Zech
P
P
D000328:Adult; D003524:Cyclosporins / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D006689:Hodgkin Disease / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D009404:Nephrotic Syndrome / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D011655:Pulmonary Embolism / Q000150:complications; D018805:Sepsis / Q000150:complications
D003524:Cyclosporins