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Tumor necrosis factor-α blocking agent as a treatment for nephrotic syndrome

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Abstract

We report a 13-year-old boy with refractory nephrotic syndrome (minimal change with mesangial proliferation) who failed the standard treatment protocols. There was some temporary response to large steroid doses, but even the Mendoza protocol could not induce remission. We show suppression of the proteinuria with Infliximab (Remicade) with tapering of steroids. Serial serum levels of tumor necrosis factor (TNF)-α are shown and discussed. We suggest studying the TNF-α blocking agents as optional treatment for nephrotic syndrome.

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Acknowledgement

It is important to note that the first author of this report is the patient’s father. The impact that this relationship may have had on treatment decisions for the patient has been carefully considered by all of the authors. The treatment protocol received support from other medical experts, as well as the approval of the local Helsinki committee.

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Authors and Affiliations

  1. Division of Internal Medicine, Shaare Zedek Medical Center, Jerusalem, Israel

    David Raveh, Ovadia Shemesh, Yaakov Jack Ashkenazi & Robert Winkler

  2. Immunology Laboratory, Oncology Department, Hadassah Medical Center, Jerusalem, Israel

    Vivian Barak

  3. Infectious Disease Unit, Shaare Zedek Medical Center, Jerusalem, Israel

    David Raveh

Authors
  1. David Raveh
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  2. Ovadia Shemesh
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  3. Yaakov Jack Ashkenazi
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  4. Robert Winkler
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  5. Vivian Barak
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Corresponding author

Correspondence to David Raveh.

Additional information

Editorial comment Before the decision was made to accept this report for publication, it was carefully considered by both medical and ethical experts with special regard for the acknowledged relationship between the patient and one of the treating physicians. We believe that this “hypothesis paper” may be of interest to our readership.

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Raveh, D., Shemesh, O., Ashkenazi, Y.J. et al. Tumor necrosis factor-α blocking agent as a treatment for nephrotic syndrome. Pediatr Nephrol 19, 1281–1284 (2004). https://doi.org/10.1007/s00467-004-1573-2

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  • DOI: https://doi.org/10.1007/s00467-004-1573-2

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