Kumasaka Ryuichiro, Nakamura Norio, Shirato Kenichi, Fujita Takeshi, Murakami Reiichi, Shimada Michiko, Nakamura Masayuki, Osawa Hiroshi, Yamabe Hideaki, Okumura Ken
The Second Department of Internal Medicine, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
Clin Exp Nephrol. 2006 Sep;10(3):222-5. doi: 10.1007/s10157-006-0424-9.
A 43-year-old woman with multiple sclerosis (MS) had nephrotic syndrome 21 months after starting treatment with interferon (IFN)-beta-1b (subcutaneous administration). She had taken no drug except for the IFN-beta-1b. Because nephrotic syndrome may be induced by IFN therapy, the IFN was stopped. Percutaneous renal biopsy revealed that she had minimal change nephrotic syndrome. As nephrotic-range proteinuria, hypoalbuminemia, and general edema were worsening even 2 weeks after cessation of the drug, oral corticosteroid therapy (prednisolone 40 mg/day) was started. The nephrotic syndrome was treated successfully with prednisolone. The dosage of prednisolone was tapered, without a relapse, and then the corticosteroid therapy was stopped. IFN-beta-1b therapy was then resumed, and the patient is in remission for both nephrotic syndrome and MS. Though proteinuria and nephrotic syndrome is a rare adverse effect of IFN-beta-1b therapy, physicians treating MS patients with this agent should pay careful attention to new clinical symptoms and laboratory findings.
一名43岁的多发性硬化症（MS）女性患者，在开始皮下注射干扰素（IFN）-β-1b治疗21个月后出现肾病综合征。除IFN-β-1b外，她未服用其他药物。由于肾病综合征可能由IFN治疗诱发，遂停用IFN。经皮肾活检显示她患有微小病变型肾病综合征。即使在停药2周后，肾病范围的蛋白尿、低白蛋白血症和全身水肿仍在加重，于是开始口服皮质类固醇治疗（泼尼松龙40毫克/天）。泼尼松龙成功治疗了肾病综合征。泼尼松龙剂量逐渐减少，未出现复发，随后停止皮质类固醇治疗。然后恢复IFN-β-1b治疗，患者的肾病综合征和MS均处于缓解期。虽然蛋白尿和肾病综合征是IFN-β-1b治疗罕见的不良反应，但使用该药物治疗MS患者的医生应密切关注新的临床症状和实验室检查结果。
