Use of tacrolimus in steroid- and cyclophosphamide-resistant minimal change nephrotic syndrome.
The authors report a case of adult-onset minimal change nephrotic syndrome (MCNS) that was resistant to steroid and cyclophosphamide therapy. Introduction of cyclosporin induced an usual cutaneous reaction of severe flushing attacks. Tacrolimus successfully alleviated both the nephrotic syndrome and the cutaneous side effect associated with cyclosporin use. The antiproteinuric mechanisms of tacrolimus and its potential in treating refractory MCNS and other forms of primary glomerulonephritides are discussed.
Tang
Sydney
S
Division of Nephrology, Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Hong Kong. scwtang@hkucc.hku.hk
Tang
Anthony W C
AW
Tam
Man Kei
MK
Ho
Yiu Wing
YW
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D016572:Cyclosporine / Q000009:adverse effects; D003875:Drug Eruptions / Q000209:etiology; D004351:Drug Resistance; D005260:Female; D005483:Flushing / Q000139:chemically induced; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D009402:Nephrosis, Lipoid / Q000188:drug therapy*; D011239:Prednisolone / Q000627:therapeutic use; D012074:Remission Induction; D013256:Steroids / Q000627:therapeutic use; D016559:Tacrolimus / Q000627:therapeutic use*
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D013256:Steroids; D016572:Cyclosporine; D003520:Cyclophosphamide; D011239:Prednisolone; D016559:Tacrolimus