PMID- 38034245
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231202
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 10
DP  - 2023 Oct
TI  - Suplatast Tosilate and Eicosapentaenoic Acid as a Possible Strategy for 
      Maintaining Remission in Minimal Change Nephrotic Syndrome: A Case Report.
PG  - e48048
LID - 10.7759/cureus.48048 [doi]
LID - e48048
AB  - We report a case of a sudden onset of minimal change nephrotic syndrome (MCNS) in 
      a 33-year-old woman with type 1 diabetes mellitus (T1DM), stable 
      microalbuminuria, and chronic thyroiditis. She was successfully treated with 
      intravenous corticosteroids to finally attain a complete remission. Four years 
      later, she also experienced a relapse of MCNS in the same season as the first 
      onset. The chronological levels of serum immunoglobulin E (IgE) showed that 
      extremely high serum IgE levels preceded the onset or the relapse of MCNS, which 
      may suggest an allergic mechanism of MCNS. Eicosapentaenoic acid (EPA) was 
      reported to be beneficial in treating allergic diseases. Suplatast tosilate is an 
      anti-allergic medication that suppresses serum IgE and was reported to be 
      beneficial in reducing corticosteroid dose in nephrotic syndrome in a pilot 
      study. Therefore, during the tapering of corticosteroids to the relapse of MCNS, 
      suplatast tosilate and EPA were administered, and the IgE levels were 
      considerably controlled. The patient was able to maintain remission even after 
      the cessation of corticosteroids. In conclusion, suppressing IgE levels using 
      suplatast tosilate and EPA may be beneficial in maintaining complete remission 
      without corticosteroids in T1DM.
CI  - Copyright (c) 2023, Shichijo et al.
FAU - Shichijo, Ayako Y
AU  - Shichijo AY
AD  - Nephrology, National Hospital Organization Osaka National Hospital, Osaka, JPN.
FAU - Iwatani, Hirotsugu
AU  - Iwatani H
AD  - Nephrology, National Hospital Organization Osaka National Hospital, Osaka, JPN.
LA  - eng
PT  - Case Reports
DEP - 20231031
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10688509
OTO - NOTNLM
OT  - chronic thyroiditis
OT  - continuous glucose monitoring
OT  - corticosteroid
OT  - eicosapentaenoic acid
OT  - foxp3
OT  - ige
OT  - minimal change nephrotic syndrome
OT  - remission
OT  - suplatast tosilate
OT  - type 1 diabetes
COIS- The authors have declared financial relationships, which are detailed in the next 
      section.
EDAT- 2023/11/30 18:45
MHDA- 2023/11/30 18:46
PMCR- 2023/10/31
CRDT- 2023/11/30 17:30
PHST- 2023/10/19 00:00 [accepted]
PHST- 2023/11/30 18:46 [medline]
PHST- 2023/11/30 18:45 [pubmed]
PHST- 2023/11/30 17:30 [entrez]
PHST- 2023/10/31 00:00 [pmc-release]
AID - 10.7759/cureus.48048 [doi]
PST - epublish
SO  - Cureus. 2023 Oct 31;15(10):e48048. doi: 10.7759/cureus.48048. eCollection 2023 
      Oct.