A case of hypertrophic cardiomyopathy complaining of chest pain during treatment for nephrotic syndrome

Abstract

We report a case of myocardial hypertrophy during treatment for nephrotic syndrome (NS). Initially, the hypertrophy was thought to be the effect of glucocorticoid (GC) because it was recovered after GC was discontinued. However, myocardial hypertrophy gradually progressed after GC was stopped. According to myocardial thickness over 13 mm and his family history of cardiomyopathy, he was diagnosed with hypertrophic cardiomyopathy. Myocardial hypertrophy was exacerbated again by the resumption of GC treatment, suggesting that GC could be deteriorating factors of myocardial thickening. GC is widely used for treatment for many diseases, including NS. In addition, hypertrophic cardiomyopathy is not a rare disease in Japan, which is 374 per 100,000 population. In administering GC, the cardiac assessment will be mandatory especially in cases with family history of myocardial disease.