Cui KH, Zhang H, Tao YH. Idiopathic membranous nephropathy in children: A case report. World J Clin Cases 2022; 10(16): 5387-5393 [PMID: 35812651 DOI: 10.12998/wjcc.v10.i16.5387]
Corresponding Author of This Article
Hui Zhang, MD, Adjunct Professor, Doctor, Department of Pediatrics, West China Second University Hospital of Sichuan University, No. 28 Section 3, Renmin South Road, Chengdu 610041, Sichuan Province, China. zhanghui20210430@126.com
Research Domain of This Article
Pediatrics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jun 6, 2022; 10(16): 5387-5393 Published online Jun 6, 2022. doi: 10.12998/wjcc.v10.i16.5387
Idiopathic membranous nephropathy in children: A case report
Kun-Hua Cui, Hui Zhang, Yu-Hong Tao
Kun-Hua Cui, Hui Zhang, Yu-Hong Tao, Department of Pediatrics, West China Second University Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Kun-Hua Cui, Hui Zhang, Yu-Hong Tao, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, Sichuan Province, China
Author contributions: Cui KH collated the patient data and drafted the manuscript; Zhang H analyzed the patient’s clinical course and outcomes, interpreted the findings, and critically reviewed the manuscript; Tao YH helped modify the manuscript; all authors read, critically reviewed, and provided feedback on the manuscript; and all authors approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui Zhang, MD, Adjunct Professor, Doctor, Department of Pediatrics, West China Second University Hospital of Sichuan University, No. 28 Section 3, Renmin South Road, Chengdu 610041, Sichuan Province, China. zhanghui20210430@126.com
Received: September 10, 2021 Peer-review started: September 10, 2021 First decision: November 22, 2021 Revised: December 5, 2021 Accepted: April 24, 2022 Article in press: April 24, 2022 Published online: June 6, 2022 Processing time: 264 Days and 19 Hours
Abstract
BACKGROUND
Minimal change disease is a common cause of nephrotic syndrome (NS) in children and has a good prognosis. Idiopathic membranous nephropathy (IMN), a rare cause of NS in children, may progress to chronic kidney disease. However, there is little data on how to evaluate and treat IMN in children.
CASE SUMMARY
In this article, we report the case of a 7-year-old boy with steroid-resistant NS. After cyclophosphamide pulse therapy combined with oral prednisone, the urinary protein results remained positive. Renal biopsy confirmed the pathological diagnosis of stage II MN, with positivity for phospholipase A2 receptor. Other immunological and infectious diseases relevant to secondary MN were ruled out by laboratory tests. Subsequently, tacrolimus plus prednisone was administered, and the therapeutic effect was satisfactory.
CONCLUSION
IMN is rare in children. The main clinical manifestation is NS. The diagnosis depends on renal biopsy. There is little evidence-based data on the treatment of IMN in children. Therefore, large-sample randomized controlled trials need to be performed. Individualized treatment should be used to improve the prognosis of the disease.
Core Tip: Here, we report the case of a school-age boy with idiopathic membranous nephropathy (IMN). IMN was diagnosed after treatment with steroids and immunosuppressants for several weeks by renal biopsy. This case highlights that individualized treatment can be used to improve the prognosis of the disease. Phospholipase A2 receptor antibody levels may be valuable for early diagnosis, treatment monitoring, and follow-up.
