title: [Nephrotic syndrome in Crohn's disease].
abstract: BACKGROUND
  The differential diagnosis of nephrotic syndrome is diverse. Systemic conditions and medication such as NSAIDs can cause this syndrome.
  
  
  METHODS
  A 33-year-old male with Crohn's disease for which he was receiving adalimumab noticed he was gaining weight and had swollen ankles. Examination revealed nephrotic syndrome without renal insufficiency. Renal biopsy showed a membranous glomerulopathy. We excluded secondary causes of membranous glomerulopathy such as diabetes mellitus, systemic lupus erythematosus, viral infection or malignancy. We treated the patient with high-dose glucocorticoids on a weaning schedule and adalimumab was discontinued. This regimen resulted in complete remission. It is likely that the nephrotic syndrome with membranous glomerulopathy was associated with adalimumab.
  
  
  CONCLUSIONS
  In patients with nephrotic syndrome based on membranous glomerulopathy both primary and secondary causes, such as use of medication, need to be excluded.
authors: Albert Schweitzer Ziekenhuis, Dordrecht.
authors: H J Henk-Jan
authors: HJ
authors: Boiten
authors: Pieter
authors: P
authors: Honkoop
authors: Peter J H
authors: PJ
authors: Smak Gregoor
mesh_terms: D000068879:Adalimumab / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy; D015433:Glomerulonephritis, Membranous / Q000139:chemically induced / Q000175:diagnosis* / Q000188:drug therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009404:Nephrotic Syndrome / Q000139:chemically induced / Q000175:diagnosis* / Q000188:drug therapy; D012074:Remission Induction
chemical_list: D005938:Glucocorticoids; D000068879:Adalimumab