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Nephrotic syndrome with focal segmental glomerulosclerosis after an insect bite
1Outpatient Department of Nephrology, St. John's Hospital, Budapest, Hungary. drrt@t-online.hu
Clinical Nephrology
|August 31, 2006
Summary
Nephrotic syndrome developed after an insect bite in a patient with focal segmental glomerulosclerosis (FSGS). Cyclophosphamide successfully treated this steroid-resistant condition, suggesting an immune response triggered by the bite.
Area of Science:
- Nephrology
- Immunology
- Toxicology
Background:
- Focal segmental glomerulosclerosis (FSGS) is a significant cause of nephrotic syndrome.
- Nephrotic syndrome post-insect sting is exceptionally rare.
- The hallmark of FSGS is significant proteinuria, often nephrotic range.
Observation:
- A 51-year-old female developed nephrotic syndrome and FSGS with a glomerular tip lesion after an insect bite.
- Initial presentation included generalized edema and 7g/24h proteinuria.
- The patient's nephrotic syndrome was resistant to steroid treatment.
Findings:
- Renal biopsy confirmed FSGS, tip variant.
- Treatment with cyclophosphamide for 8 weeks induced complete remission.
- No relapse occurred during a 2-month follow-up period.
Implications:
- This case suggests a potential causal link between insect bites and FSGS-induced nephrotic syndrome.
- An immune-mediated response to the insect bite may trigger FSGS.
- Cyclophosphamide is a viable treatment option for steroid-resistant FSGS with glomerular tip lesions.
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