Improvement of nephrotic syndrome by intensive lipid-lowering therapy in a patient with lipoprotein glomerulopathy

  • Akira Matsunaga
  • Masayuki Furuyama
  • Taeko Hashimoto
  • Kentaro Toyoda
  • Daisuke Ogino
  • Kiyoshi Hayasaka
Case Report

DOI: 10.1007/s10157-009-0207-1

Cite this article as:
Matsunaga, A., Furuyama, M., Hashimoto, T. et al. Clin Exp Nephrol (2009) 13: 659. doi:10.1007/s10157-009-0207-1
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Abstract

Lipoprotein glomerulopathy (LPG) is a rare hereditary disease characterized by the accumulation of much thrombi material consisting of lipoproteins at the glomerular capillary lumen. Most patients show nephrotic syndrome; nearly half progress to chronic renal failure. Intensive therapy with lipid-lowering agents reportedly engenders clinical remission with histological resolution. We report the case of a 14-year-old Japanese female patient who had been in a nephrotic condition with hematuria from 4 years old and who had been diagnosed based on pathological and molecular examination at 7 years old. We initially treated the patient with probucol, enalapril (angiotensin-converting enzyme inhibitor: ACEI), and dipyridamole from age 7, but achieved no improvement in her nephrotic status. Subsequently, we replaced probucol with bezafibrate at age 11 and added atorvastatin calcium hydrate and valsartan (angiotensin II receptor blocker: ARB) the following year. The next 3 years’ treatment improved her nephrotic status, decreased serum apolipoprotein E, and markedly decreased intraglomerular lipoprotein thrombi. Early and intensive therapy with antilipidemic drugs combined with ACEI and ARB is inferred to be effective for LPG.

Keywords

Lipoprotein glomerulopathy LPG Apolipoprotein E ApoE Antilipidemic drug 

Copyright information

© Japanese Society of Nephrology 2009

Authors and Affiliations

  • Akira Matsunaga
    • 1
  • Masayuki Furuyama
    • 1
  • Taeko Hashimoto
    • 1
  • Kentaro Toyoda
    • 1
  • Daisuke Ogino
    • 1
  • Kiyoshi Hayasaka
    • 1
  1. 1.Department of PediatricsYamagata University School of MedicineYamagataJapan

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