Altered response to conventional therapy after correction of hyperlipidemia by plasma exchange and pravastatin in a case of intractable primary focal segmental glomerulosclerosis.

Abstract

There is no established treatment for intractable primary focal segmental glomerulosclerosis (FSGS). Recently plasma exchange and low-density lipoprotein apheresis were added to the treatment regimen. This report documents a case of 11-year boy with intractable primary FSGS who could achieve remission after the intensive treatment with plasma exchange and intravenous pulse methylprednisolone. He experienced frequent relapses despite the treatment with high-dose CsA. However, the dose of oral prednisone could be reduced after correction of hypercholesterolemia by the initiation of pravastatin.
The case indicates that correction of hyperlipidemia by plasma exchange and antihyperlipidemic agents might play a favorable role in altered response to conventional therapy, such as corticosteroid or CsA, for the patient with primary FSGS.