Steroid-resistant minimal change nephrotic syndrome associated with thymoma treated effectively with rituximab following thymectomy and cyclosporine: a case report

期刊论文
出版模式：

开放获取
发表日期：

2024年2月9日

查看全文

Yusaku Watanabe,
Keiji Hirai,
Momoko Hirata,
Taisuke Kitano,
Kiyonori Ito,
Susumu Ookawara,
Hisashi Oshiro,
Yoshiyuki Morishita

摘要

Background

Minimal change nephrotic syndrome (MCNS) can be complicated by thymoma; however, no standard therapy for thymoma-associated MCNS has yet been established. We herein describe a case of steroid-resistant MCNS associated with thymoma, treated effectively with rituximab.

Case presentation

A 71-year-old Japanese man was referred to our department with severe proteinuria (20 g/gCr). Renal biopsy showed minimal change disease and computed tomography revealed an anterior mediastinal mass. Based on these findings, he was diagnosed with thymoma-associated MCNS. He was treated with oral prednisolone (50 mg/day) and cyclosporine, and underwent thymectomy and plasma exchange. However, no improvement in proteinuria was observed. He therefore received intravenous rituximab 500 mg, resulting in a marked decrease in proteinuria from 5328 to 336 mg/day after 1 week.

Conclusions

This case suggests that rituximab might be an effective therapy in patients with steroid-resistant MCNS associated with thymoma.