title: Successful treatment of adult IgA nephropathy with nephrotic-level proteinuria by combination therapy including long-term coadministration of mizoribine.
abstract: A 41-year-old male patient was admitted to our hospital due to massive proteinuria and hematuria. His 24-hour urinary protein excretion and the number of urinary erythrocytes were 3.91 g/day and 50-99/high-power field, respectively. A renal biopsy showed a severe pathological pattern of immunoglobulin A nephropathy (IgAN) that involved marked endocapillary proliferation and segmental sclerosis (Oxford-MEST score: M0, E1, S1, T0). Because he had nephrotic-level proteinuria with severe pathological findings, which are tonsillectomy and corticosteroid pulse therapy-resistant characteristics, he received mizoribine for a long period as part of the combination therapy using corticosteroid, tonsillectomy, dipyridamole, warfarin and renin-angiotensin-aldosterone system blockers. Twelve months after the beginning of treatment, his urinary findings were normal. In this report, we describe the pathological findings and successful treatment course, and discuss the potential effects of long-term coadministration of mizoribine for adult IgAN treatment.
authors.affiliation: Division of Kidney and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Sendai, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Okonogi
authors.forename: Tetsuya
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authors.lastname: Kawamura
authors.forename: Nanae
authors.initials: N
authors.lastname: Matsuo
authors.forename: Yasuto
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authors.lastname: Takahashi
authors.forename: Izumi
authors.initials: I
authors.lastname: Yamamoto
authors.forename: Hiraku
authors.initials: H
authors.lastname: Yoshida
authors.forename: Kentaro
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authors.lastname: Koike
authors.forename: Takashi
authors.initials: T
authors.lastname: Yokoo
authors.forename: Kensuke
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authors.lastname: Joh
authors.forename: Yasunori
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authors.lastname: Utsunomiya
authors.forename: Kazushige
authors.initials: K
authors.lastname: Hanaoka
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Hosoya