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Membranous glomerulopathy and treatment with Acthar®: a case study

Authors Watson MJ

Received 28 June 2013

Accepted for publication 11 August 2013

Published 21 October 2013 Volume 2013:6 Pages 229—232


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Myra June Watson

Nephrology/Hypertension Associates, Columbia, MO, USA

Abstract: Treatment options for refractory membranous nephropathy are limited. Herein we describe the case of a 46-year-old white male with membranous nephropathy who progressed during 3 years of treatment with antihypertensive agents (specifically angiotensin-converting enzyme inhibitors and angiotensin receptor blockers), diuretics, simvastatin, prednisone, cyclosporine A, and mycophenolate mofetil. Prior to initiation of treatment with H.P. Acthar® Gel, his proteinuria level was 9,520 mg/dL (952.0 g/L) but it decreased to 2,948 mg/dL (294.8 g/L) after 10 months of Acthar therapy. After 13 months, treatment with Acthar was halted as his 24-hour urinary protein was 1,628 mg/dL (162.8 g/L); by 15 months, it was 407 mg/dL (40.7 g/L). The patient has remained free of signs and symptoms of membranous nephropathy for 1.5 years. These results support the use of Acthar as an effective and safe therapy for patients with refractory membranous nephropathy.

Keywords: membranous glomerulopathy, membranous nephropathy, ACTH, proteinuria, nephrotic syndrome

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