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Successful treatment by mycophenolate mofetil in a patient with focal segmental glomerulosclerosis associated with posterior reversible encephalopathy syndrome

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Abstract

It has been reported that cyclosporine A (CsA) treatment may be associated with posterior reversible encephalopathy syndrome. We report a 16-year-old man who exhibited nephrotic syndrome and posterior reversible encephalopathy syndrome. Intensive antihypertensive therapy restored him to consciousness. Renal biopsy revealed that he suffered from focal segmental glomerulosclerosis. Although he was treated with prednisolone and low-density lipoprotein apheresis therapy, his proteinuria remained at high level. Then, mycophenolate mofetil (MMF) with less influence on vessel endothelium compared with CsA and tacrolimus was administered. Soon after, he reached remission of nephrotic syndrome without recurrence of posterior reversible encephalopathy syndrome. This is the first case that a young patient of focal segmental glomerulosclerosis with posterior reversible encephalopathy syndrome achieved a complete remission by MMF treatment without recurrence of posterior reversible encephalopathy syndrome. MMF may be effective for young patients of focal segmental glomerulosclerosis especially with clinical condition of vascular endothelial damage such as posterior reversible encephalopathy syndrome.

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Acknowledgments

We thank Yoko Saito for technical assistance for renal biopsy.

Conflict of interest

Hitoshi Sugiyama belongs to the Department of Chronic Kidney Disease and Peritoneal Dialysis which is endowed by Baxter and received research funding from Genzyme. Yohei Maeshima belongs to the Department of Chronic Kidney Disease and Cardiovascular Disease which is endowed by Chugai pharmaceutical, MSD, Boehringer Ingelheim and Kawanishi Holdings. Jun Wada received speaker honoraria from Novartis, Boeringer Ingelheim and Novo Nordisk.

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Authors and Affiliations

  1. Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, kita-ku, Okayama, 700-8558, Japan

    Masafumi Tenta, Haruhito Adam Uchida, Tomokazu Nunoue, Ryoko Umebayashi, Yuka Okuyama, Masashi Kitagawa & Jun Wada

  2. Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, kita-ku, Okayama, 700-8558, Japan

    Yohei Maeshima

  3. Department of Chronic Kidney Disease and Peritoneal Dialysis, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, kita-ku, Okayama, 700-8558, Japan

    Hitoshi Sugiyama

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  1. Masafumi Tenta
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  2. Haruhito Adam Uchida
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  3. Tomokazu Nunoue
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  5. Yuka Okuyama
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  6. Masashi Kitagawa
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  7. Yohei Maeshima
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  8. Hitoshi Sugiyama
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  9. Jun Wada
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Correspondence to Haruhito Adam Uchida.

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Tenta, M., Uchida, H.A., Nunoue, T. et al. Successful treatment by mycophenolate mofetil in a patient with focal segmental glomerulosclerosis associated with posterior reversible encephalopathy syndrome. CEN Case Rep 4, 190–195 (2015). https://doi.org/10.1007/s13730-014-0165-7

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  • DOI: https://doi.org/10.1007/s13730-014-0165-7

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