title: Nephrotic syndrome due to immunoglobulin M mesangial glomerulonephritis preceding juvenile idiopathic arthritis.
abstract: The association between nephrotic syndrome and juvenile idiopathic arthritis have rarely been described in pediatric patients. We report a child with steroid-responsive nephrotic syndrome, with frequent relapses, who presented with a new relapse of nephrotic syndrome associated with arthritis and uveitis at 21 months in remission after treatment with chlorambucil. Juvenile idiopathic arthritis was diagnosed and kidney biopsy examination showed mesangial glomerulonephritis with immunoglobulin M deposits. To our knowledge, only 2 cases of nephrotic syndrome preceding juvenile idiopathic arthritis have been reported, one without histopathology assessment and the other with minimal change disease. Although mesangial glomerulonephritis with nephrotic syndrome and juvenile idiopathic arthritis could have been coincidental, the immune pathogenic mechanism accepted for both diseases suggests they could be related.
authors.affiliation: Department of Pediatrics, Universidad de Buenos Aires, Buenos Aires Argentina. drvoyer@email.com
authors.forename: Luis E
authors.initials: LE
authors.lastname: Voyer
authors.forename: Caupolican
authors.initials: C
authors.lastname: Alvarado
authors.forename: Rubén J
authors.initials: RJ
authors.lastname: Cuttica
authors.forename: Alejandro
authors.initials: A
authors.lastname: Balestracci
authors.forename: Marta
authors.initials: M
authors.lastname: Zardini
authors.forename: Néstor
authors.initials: N
authors.lastname: Lago
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D001706:Biopsy; D002675:Child, Preschool; D002699:Chlorambucil / Q000627:therapeutic use; D005921:Glomerulonephritis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis*; D008297:Male; D050527:Mesangial Cells / Q000276:immunology* / Q000473:pathology; D009404:Nephrotic Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D013256:Steroids / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D007075:Immunoglobulin M; D013256:Steroids; D002699:Chlorambucil