XXXX @entity8 : a true immune complex disease or an immunologic epiphenomenon?

@entity1 @entity8 @entity6300 @entity7305 @entity786 @entity205 @entity1985 @entity479
We describe a 16-year-old Caucasian @entity1 who presented with @entity479 -sensitive @entity1985 aged 2 years. His clinical course was one of frequent relapses and severe @entity479 dependence. To manage this, he was sequentially treated with @entity7305 , then oral @entity786 before being started on @entity205 . A renal biopsy performed prior to commencement of @entity205 confirmed minimal change disease on light microscopy. The immunohistochemistry and electron microscopy findings were in keeping with this. His complement levels were normal and his lupus serology negative. He remained on @entity205 therapy for 8 years and had two further renal biopsies to detect @entity205 -induced @entity8 . Both biopsies showed evidence of increasing amounts of @entity6300 deposition on immunohistochemistry and the presence of immune deposits on electron microscopy. As he had continued negative lupus serology, this was compatible with a diagnosis of @entity6300 @entity8 . In addition both biopsies had changes compatible with chronic mild @entity205 nephrotoxicity. This case is the first report describing in detail a paediatric @entity1 with evolving @entity6300 @entity8 who was treated successfully with rituximab. We discuss the role of @entity6300 in this clinicopathological entity and question its significance.
