Minimal change nephrotic syndrome in an 82 year old patient following a tetanus-diphteria-poliomyelitis-vaccination

Table 1 Summary of MCNS following vaccination in literature

Vaccination against	Tetanus-diphteria-poliomyelitis-vaccination	Pneumococcus [6]	Influenza [7]	Hepatitis B [3]	Hepatitis B [4]	Hepatitis B [5]
Age [years]	82	67	65	3	40	4
Gender	female	female	female	male	female	male
Baseline creatinine	76 μmol/l	no data	normal	44 μmol/l	normal	no data
Peak creatinine	138 μmol/l	274 μmol/l	158 μmol/l	no data	no data	no data
Baseline proteinuria	negative in dip-stick	past history unremarkable	no data	past history unremarkable	past history unremarkable	past history unremarkable
Peak proteinuria	12 g/day	10.4 g/day	13.2 g/day	24.8 g/day	8 g/day	1.25 g/day
Vaccination to onset of symptoms	4 weeks	4 months	4 days	17 days	after 2^nd inoculation	8 days
Biopsy	typical minimal change lesion (MCL)	MCL and mild interstitial nephritis	typical minimal change lesion (MCL)	not indicated	minimal change nephropathy	not indicated
Treatment	Steroids 1 mg/kg bw ACE-inhibitor	750 mg Steroids for 3 days; followed by 40 mg/day	None specific	Steroids 2 mg/kg bw	Steroids (12 mg every other day)	Steroids 2 mg/kg bw
Renal function/follow up	80 μmol/l 6 months after diagnosis	Urinary protein neg. after one year; 15 mg Steroids/day	Clearacnce 95 ml/min after one year	no data	no data	Complete remission

ISSN: 1471-2369