Abstract | BACKGROUND: CASE PRESENTATION: A 59-year-old male without any episodes of proteinuria was given denosumab to treat osteoporosis. Two weeks after its administration, he noticed a foamy urine and bilateral pretibial edema. Laboratory tests revealed that he had severe proteinuria (15g/g Cr), hypoproteinemia (4.0g/dL), and hypoalbuminemia (1.5g/dL). Based on the results, he was diagnosed with nephrotic syndrome. The proteinuria selectivity index was 0.05, indicating selective proteinuria. Renal biopsy showed minor glomerular abnormality with less tubulointerstitial damage, and electron microscopy showed extensive foot process effacement, indicating MCD. With all these results, glucocorticoid therapy of 50mg/day prednisolone was started. After 4weeks of treatment, the urinary protein level remains high (3.1g/g Cr). Prednisolone therapy was continued, and the levels of proteinuria decreased gradually to the range of partial remission (1.2g/g Cr) with another 7weeks of prednisolone treatment, but complete remission was not achieved. CONCLUSIONS: This might be a case wherein RANKL inhibition is associated with the pathogenesis of MCD. Further studies will be needed to elucidate the causal relationship of RANK-RANKL signaling to the pathogenesis of MCD.
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Authors | Keisuke Horikoshi, Norihiko Sakai, Naoki Yamamoto, Hisayuki Ogura, Koichi Sato, Taro Miyagawa, Shinji Kitajima, Tadashi Toyama, Akinori Hara, Yasunori Iwata, Miho Shimizu, Kengo Furuichi, Takashi Wada |
Journal | BMC nephrology
(BMC Nephrol)
Vol. 21
Issue 1
Pg. 416
(09 29 2020)
ISSN: 1471-2369 [Electronic] England |
PMID | 32993539
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Bone Density Conservation Agents
- RANK Ligand
- Serum Albumin
- Denosumab
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Topics |
- Bone Density Conservation Agents
(adverse effects, therapeutic use)
- Denosumab
(adverse effects, therapeutic use)
- Humans
- Kidney
(pathology)
- Male
- Middle Aged
- Nephrosis, Lipoid
(chemically induced, pathology)
- Osteoporosis
(drug therapy)
- RANK Ligand
(antagonists & inhibitors)
- Serum Albumin
(analysis)
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