Resolution of typical lipoprotein glomerulopathy by intensive lipid-lowering therapy.
Lipoprotein glomerulopathy (LPG), characterized by glomerular lipoprotein thrombi, presumably composed of abnormal apolipoprotein E (apoE), leads to a progressive decline in renal function and eventually results in end-stage renal failure. A successful treatment for LPG has not yet been established. The authors treated a 36-year-old woman with LPG and exhibiting a nephrotic syndrome using an intensive lipid-lowering therapy consisting of fenofibrate (300 mg), niceritrol (750 mg), ethyl-icosapentate (1,800 mg), and probucol (500 mg). After the start of treatment, a remarkable decrease in urinary protein excretion and improvement in the hyperlipidemia were obtained; proteinuria was no longer detected 11 months after the initiation of treatment. A second biopsy performed 11 months after the initiation of treatment showed the complete disappearance of the lipoprotein thrombi that had been observed in a diffuse and global manner in the first renal biopsy. These findings suggest that typical LPG could be regressed if the abnormal lipoproteinemia is controlled sufficiently.
Ieiri
Norio
N
Department of Nephrology, Sendai Shakaihoken Hospital, Sendai, Japan. no-ieiri@pf6.so-net.ne.jp
Hotta
Osamu
O
Taguma
Yoshio
Y
D000328:Adult; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D001057:Apolipoproteins E / Q000378:metabolism; D004338:Drug Combinations; D015118:Eicosapentaenoic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D011345:Fenofibrate / Q000627:therapeutic use; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D007674:Kidney Diseases / Q000175:diagnosis* / Q000188:drug therapy*; D007678:Kidney Glomerulus / Q000187:drug effects* / Q000473:pathology* / Q000648:ultrastructure; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000378:metabolism*; D008297:Male; D008854:Microscopy, Electron; D009404:Nephrotic Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics; D009531:Niceritrol / Q000627:therapeutic use; D010375:Pedigree; D011341:Probucol / Q000627:therapeutic use
D000924:Anticholesteremic Agents; D001057:Apolipoproteins E; D004338:Drug Combinations; D000960:Hypolipidemic Agents; D008055:Lipids; D008074:Lipoproteins; C035276:eicosapentaenoic acid ethyl ester; D015118:Eicosapentaenoic Acid; D009531:Niceritrol; D011341:Probucol; D011345:Fenofibrate