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Objective: To report for the first time a case of reversible minimal change nephrotic syndrome with immunoglobulin A (IgA) deposition associated with heroin. Clinical Presentation and Intervention: A 29-year-old male heroin abuser who developed nephrotic syndrome was admitted to our clinic. Renal biopsy revealed minimal change disease with IgA deposition. Because spontaneous complete remission was observed after cessation of heroin, a diagnosis of minimal change nephrotic syndrome with IgA deposition associated with heroin abuse was considered. Conclusion: This case showed minimal change nephrotic syndrome with IgA deposition that had a benign clinical course.

Background: Novel biomarkers are needed to predict the response to treatment in patients with nephrotic syndrome (NS) due to primary glomerulonephritides (PGN). We aimed to test the predictive value of red blood cell distribution width (RDW) for estimation of response to therapy in adult patients with NS. Study design, setting & participants, and intervention: We performed a prospective study including 176 patients with NS due to PGN. Patients were divided into three groups according to their response to the treatment. Group 1 was composed of patients with complete remission whereas group 2 was composed of patients with partial remission and group 3 was composed of patients who were resistant to the treatment. Results: The highest baseline mean RDW value was found in group 3 patients (17.8 ± 1.8) whereas the lowest in group 1 (13.4 ± 0.7) before treatment (p50.05). We found a significant decrease in RDW value after an effective treatment in groups 1 and group 2 (p50.05). However, there was no significant change in RDW values after treatment in group 3 (p40.05). Most of the patient with complete remission had base-line RDW level 14% (n ¼ 45, 90%) (p50.001, Kendal Tau: À0.86), and most of the patients who were resistant to the treatment had base-line RDW level p415% (n ¼ 68, 86.1%) (p50.001, Kendal Tau: À0.87). Conclusion: Our results suggest that pre-treatment RDW value is a promising novel biomarker for predicting response to the treatment in adult patients with NS due to PGN.

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