Membranous nephropathy with severe tubulointerstitial and vascular changes in a patient with psoriatic arthritis treated with non-steroidal anti-inflammatory drugs.
We report on a patient who suffered from psoriasis vulgaris and psoriatic arthritis and developed nephrotic syndrome after long-term therapy with non-steroidal anti-inflammatory drugs. Membranous nephropathy with tubulointerstitial and vascular (intimal hyperplasia) changes were found on renal biopsy using optical, immunofluorescent and electron microscopy. Treatment with methylprednisolone "pulse" therapy (1 g/24 h during 3 days) and continuing with prednisone 0.5 mg/kg/24 h was ineffective and end-stage renal failure developed 6 months after the diagnosis had been established.
Department of Nephrology, Faculty of Medicine, Skopje, Macedonia.
L
L
Grcevska
M
M
Polenaković
D
D
Ferluga
A
A
Vizjak
G
G
Stavrić
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000150:complications / Q000188:drug therapy*; D001706:Biopsy; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007676:Kidney Failure, Chronic / Q000209:etiology; D008775:Methylprednisolone / Q000627:therapeutic use; D008854:Microscopy, Electron; D008856:Microscopy, Fluorescence; D011241:Prednisone / Q000627:therapeutic use; D013997:Time Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D011241:Prednisone; D008775:Methylprednisolone