Successful treatment of a patient with refractory nephrotic syndrome with PCSK9 inhibitors: a case report

BMC Nephrology

Case Report

Yuji Ikeda¹  Yasunori Nonaka¹  Tsuyoshi Takashima¹  Masatora Yamasaki¹  Motoaki Miyazono¹  Keiichiro Matsumoto¹  Yuki Awanami¹  Makoto Fukuda¹ 

[1] Department of Internal Medicine, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga, Japan;

关键词: Proprotein convertase subtilisin/kexin type 9 (PCSK9);    Evolocumab;    Nephrotic syndrome;    Case report;   

DOI  :  10.1186/s12882-017-0644-0

 received in 2016-11-21, accepted in 2017-06-28,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor evolocumab is a low-density lipoprotein (LDL)-lowering drug with a new mechanism, which is currently available in Japan. Here, for the first time, we report the successful use of the PCSK9 inhibitor in a patient with refractory nephrotic syndrome.Case presentationA 61-year-old woman was diagnosed with minimal change-type nephrotic syndrome in October 2012. She received prednisolone (PSL) and cyclosporin A (CyA), but she experienced several cycles of relapse and remission and was hospitalized in May 2016 due to relapse. However, in spite of steroid pulse therapy and adrenocorticotropic hormone (ACTH) administration, her urinary protein level did not improve. We started her on evolocumab with the expectation of equivalent LDL-lowering effects as seen with LDL apheresis. After that, the LDL cholesterol level and UP/UC were concomitantly decreased, and the serum albumin was increased. This was maintained even when we reduced the PSL dose. This suggests that evolocumab clinically improves the nephrotic condition.ConclusionNo other report has described the use of evolocumab for nephrotic syndrome (NS) or its effect on similar nephrotic conditions. We believe that the findings presented here are unique and may be beneficial when treating similar cases.

【 授权许可】

CC BY   
© The Author(s). 2017