Minimal change glomerulonephritis

Hematologic diseases autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura, pernicous anemia Kidney disease Goodpasture syndrom, lipoid nephroses, minimal change glomerulonephritis Diseases of the gastrointestinal tract autoimmune chronic active hepatitis, autoimmune atrophic gastritis, Crohn s disease, ulcerative colitis... 

A review of 15 other available reports of renal insufficiency and proteinuria in patients with chronic myeloid leukemia or other malignancies confirmed that the histological spectrum of renal lesions associated with interferon alfa is varied, and includes membranous glomerulonephritis, minimal change glomerulonephritis, acute interstitial nephritis, hemolytic-uremic sjmdrome, and thrombotic microangiopathy. Renal comphcations were reversible in nine patients three patients had persistent proteinuria, and four had persistent renal dysfunction, of whom three required chronic hemodialysis. Two-thirds of the patients developed renal comphcations within 1 month of treatment with interferon alfa, and one-third had received a relatively low dosage of interferon alfa (9-15 MU/week). 

Glomerulonephritis may be associated with chronic inflammatory bowel disease and has a heterogeneous expression [113]. Minimal change glomerulonephritis, membranous, membranoprohferative, focal glomerulosclerosis, and proliferative crescentic glomerulonephritis have been described and a summary of these case reports is available in the paper of Wilcox et al. [114]. In almost half of these cases, there was no relationship with drug intake such as sulphasalazine or 5-ASA. 

Rettmar K, Kienast J, van de Loo J Minimal change glomerulonephritis with reversible proteinuria during interferon alpha 2a therapy for chronic myeloid leukemia. Am J Hematol 1995,49 355-356... 

Faick HM, Tornooth T, Kock B, Wegelius O. Fatal renal vasculitis with minimal change glomerulonephritis complicating treatment with penicillamine. Acta Med Scand 1979 205 133-138. 

Acute glomerulonephritis (50) and minimal-change nephrotic sjmdrome (51) have been attributed to hepatitis B vaccine. 

Some degree of renal damage occurs in about 10% of patients taking tiopronin (1-3,5,6). As with penicillamine, proteinuria can progress to nephrotic syndrome (13,14). Biopsy may show minimal change membranous glomerulonephritis and granular depositions of IgG and C3 (13,15). 

Among all the types of glomerulonephritis, minimal-change nephropathy is most responsive to treatment. Steroids can induce good responses in most patients during initial treatment as well as relapse. 

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