Minimal change disease in association with fire coral (Millepora species) exposure

Area of Science:

• Nephrology
• Toxicology

Background:

• Minimal change disease (MCD) is a leading cause of nephrotic syndrome in children and adults.
• Various agents, including medications and allergens, have been linked to MCD.
• The spectrum of potential triggers for MCD remains incompletely understood.

Observation:

• A 45-year-old woman developed nephrotic syndrome, acute renal failure, pulmonary edema, and required intubation.
• These symptoms emerged after scuba diving exposure to fire coral (Millepora species).
• Renal biopsy confirmed the diagnosis of minimal change disease.

Findings:

• The case presents a novel association between fire coral exposure and the development of minimal change disease.
• Corticosteroid therapy led to symptomatic improvement and remission of proteinuria.
• This suggests a potential causal link between fire coral envenomation and MCD.

Implications:

• Physicians, especially in regions with fire coral, should consider MCD in patients presenting with proteinuria after potential exposure.
• Early recognition and treatment of MCD following fire coral exposure may prevent severe renal complications.
• Further research is warranted to elucidate the mechanism of fire coral-induced MCD.