title: Minimal change disease in association with fire coral (Millepora species) exposure.
abstract: Numerous agents have been associated with minimal change disease. We describe a previously unreported association in a 45-year-old white woman of scuba diving exposure to fire coral (Millepora species) that was followed by the development of nephrotic syndrome, acute renal failure, pulmonary edema, and intubation. The renal biopsy specimen was consistent with minimal change disease. Institution of corticosteroid therapy resulted in symptomatic improvement and resolution of proteinuria. Physicians, particularly those in scuba-diving areas, should consider minimal change disease in exposed patients with proteinuria because a prompt diagnostic and therapeutic approach may potentially limit complications.
authors.affiliation: Division of Nephrology, Department of Medicine, St Michael's Hospital, University of Toronto, Ontario, Canada. prasadr@smh.toronto.on.ca
authors.forename: G V Ramesh
authors.initials: GV
authors.lastname: Prasad
authors.forename: Lloyd
authors.initials: L
authors.lastname: Vincent
authors.forename: Robert
authors.initials: R
authors.lastname: Hamilton
authors.forename: Ki
authors.initials: K
authors.lastname: Lim
mesh_terms: D058186:Acute Kidney Injury / Q000188:drug therapy / Q000209:etiology; D000818:Animals; D037421:Anthozoa; D001460:Barbados; D001733:Bites and Stings / Q000150:complications*; D003131:Combined Modality Therapy; D004242:Diving; D004487:Edema / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005543:Forearm Injuries / Q000150:complications; D005665:Furosemide / Q000627:therapeutic use; D006801:Humans; D006830:Hydralazine / Q000627:therapeutic use; D007442:Intubation, Intratracheal; D007741:Labetalol / Q000627:therapeutic use; D008387:Marine Toxins / Q000009:adverse effects*; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications; D009402:Nephrosis, Lipoid / Q000209:etiology*; D009404:Nephrotic Syndrome / Q000188:drug therapy / Q000209:etiology; D011241:Prednisone / Q000627:therapeutic use; D011654:Pulmonary Edema / Q000188:drug therapy / Q000209:etiology / Q000628:therapy; D017257:Ramipril / Q000627:therapeutic use
chemical_list: D008387:Marine Toxins; D006830:Hydralazine; D005665:Furosemide; D017257:Ramipril; D007741:Labetalol; D011241:Prednisone