Recurrent lymphomatoid papulosis associated with nephrotic syndrome. An occurrence of uncertain origin.
We report on a 10-year-old child with nephrotic syndrome who developed recurrent lymphomatoid papulosis (LYP) 60 months after the first episode of proteinuria. LYP appeared when the child was taking low-dose cyclosporin and disappeared after the drug was replaced by prednisone at doses utilized for nephrotic syndrome (2 mg/kg). During the tapering of steroids, when the child was treated with low-dose prednisone (0.2 mg/kg), both LYP and nephrotic syndrome started again and required the reintroduction of prednisone to restore a normal clinical situation. This is the first case of LYP occurring in concomitance and synchronous with nephrotic syndrome. LYP was unrelated to cyclosporin (second episode after its withdrawn) but preceded the recurrence of proteinuria, suggesting a relationship with the disease activity. Even though the etiology of LYP is, in this case, uncertain, it should be considered as a clinical association of nephrotic syndrome in children and also included among potential triggers of the disease.
Ghiggeri
Gian Marco
GM
Laboratory on Pathophysiology of Uremia, G. Gaslini Children Hospital, Largo G. Gaslini 5, 16148, Genova, Italy. labnefro@ospedale-gaslini.ge.it
Bleid
Dario
D
Garaventa
Alberto
A
Coccia
Cristina
C
Gambini
Claudio
C
Caridi
Gianluca
G
Perfumo
Francesco
F
D002648:Child; D016572:Cyclosporine / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017731:Lymphomatoid Papulosis / Q000150:complications / Q000473:pathology*; D008297:Male; D009404:Nephrotic Syndrome / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D011241:Prednisone / Q000627:therapeutic use; D011507:Proteinuria / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D012008:Recurrence
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011241:Prednisone