It is now commonplace for patients to find that a drug such as prednisone, usually prescribed for relief of allergic and rheumatic symptoms, is also prescribed to treat leukemia.
According to a recent article in PubMed, prednisone, which is similar to cortisone, successfully sustained a remission when used to treat a twenty-seven-year-old patient diagnosed with glomerulopathy with fibronectin deposits (GFND).
About GFND
GFND is a rare disease with symptoms that include abnormal amounts of protein in the patient’s urine (proteinuria). These symptoms may be an indication of damaged kidneys or irreversible kidney failure (end-stage renal disease).
Hematuria, or evidence of blood in the urine, and renal failure are associated with GFND. The onset of the disease usually begins in mid-life but it may appear at any age.
Physicians have been unable to stabilize the condition. There are methods used to control blood pressure as well as the use of angiotensin-converting enzyme (ACE) inhibitors. The ACE inhibitors treat heart failure, hypertension, renal diseases, and other cardiovascular disorders.
About the Case Study
The subject was a Caucasian woman who was twenty-seven years old. She came to the clinic after experiencing proteinuria for three days. Her blood pressure and serum creatinine were in a normal range. She was unmedicated at that point.
Her family has a history of glomerular disease. Three members of her family, all young adults, died of cerebral hemorrhage and stroke.
Doctors performed a biopsy of the patient’s kidney. The scan indicated the existence of fibronectin as it relates to GFND. Fibronectin is responsible for growth, cell adhesion, migration, and the changing of cell types (differentiation). If fibronectin has been altered in any way the results may be devastating and could lead to scarring or thickening of tissue (fibrosis) or cancer.
However, in the case of this young woman, the physicians did not find interstitial fibrosis. She was treated with ACE inhibitors at maximum dosage, yet the proteinuria increased. The doctors then used prednisone daily at 60mg for two months. It was tapered by 0.2mg each month for a total of six months.
The proteinuria decreased and the serum creatinine remained stable during the five-year follow-up. There were no significant adverse events.
Looking Forward
The doctors who attended to the young woman recommend that in the future, prednisone should be considered for GFND patients who have nephrotic proteinuria.
