Nephrotic syndrome associated with interferon-beta-1b therapy for multiple sclerosis.
A 43-year-old woman with multiple sclerosis (MS) had nephrotic syndrome 21 months after starting treatment with interferon (IFN)-beta-1b (subcutaneous administration). She had taken no drug except for the IFN-beta-1b. Because nephrotic syndrome may be induced by IFN therapy, the IFN was stopped. Percutaneous renal biopsy revealed that she had minimal change nephrotic syndrome. As nephrotic-range proteinuria, hypoalbuminemia, and general edema were worsening even 2 weeks after cessation of the drug, oral corticosteroid therapy (prednisolone 40 mg/day) was started. The nephrotic syndrome was treated successfully with prednisolone. The dosage of prednisolone was tapered, without a relapse, and then the corticosteroid therapy was stopped. IFN-beta-1b therapy was then resumed, and the patient is in remission for both nephrotic syndrome and MS. Though proteinuria and nephrotic syndrome is a rare adverse effect of IFN-beta-1b therapy, physicians treating MS patients with this agent should pay careful attention to new clinical symptoms and laboratory findings.
Kumasaka
Ryuichiro
R
The Second Department of Internal Medicine, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan. rkuma-cc@umin.ac.jp
Nakamura
Norio
N
Shirato
Kenichi
K
Fujita
Takeshi
T
Murakami
Reiichi
R
Shimada
Michiko
M
Nakamura
Masayuki
M
Osawa
Hiroshi
H
Yamabe
Hideaki
H
Okumura
Ken
K
D000276:Adjuvants, Immunologic / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D001706:Biopsy; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000009:adverse effects* / Q000627:therapeutic use; D007668:Kidney / Q000473:pathology; D009103:Multiple Sclerosis / Q000188:drug therapy*; D009402:Nephrosis, Lipoid / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use
D000276:Adjuvants, Immunologic; D005938:Glucocorticoids; D000068576:Interferon beta-1b; D016899:Interferon-beta; D011239:Prednisolone