Work

Steroid- and immunosuppressive-resistant nephrotic syndrome in focal and segmental glomerulosclerosis and hyalinosis (FSGSH) with progressive chronic kidney disease: diagnostic and therapeutic challenges

Year: 2026

Type: article

Abstract: This report presents a complex case of an 18-year-old patient with multiresistant nephrotic syndrome secondary to focal and segmental glomerulosclerosis and hyalinosis (FSGSH), characterized by massive proteinuria (47 to 11 g/24 h), severe hypoproteinemia (albumin 6–17 g/L), immunologic abnormalities (C3, IgM, and C1q deposits), dysregulation of the alternative complement pathway, and a lack of response to standard, combined, and biological therapies. The clinical course included a progressive decline in eGFR, development of anemia, hypercoagulability, infectious complications, and the need for ultrafiltration and hemodialysis. This case reflects the therapeutic limitations in FSGSH and highlights the need for personalized, pathophysiology-based treatment strategies.

Source: Pharmacia

DOI: 10.3897/pharmacia.73.e182594

Authors: Dimitar Nikolov, George Nikolov, Spas Kitov, Maria-Florance Kitova, Anna A. Mihaylova, Lyudmila Kitova

Institution: Medical University Plovdiv

Language: English

Topic: Renal Diseases and Glomerulopathies

Subfield: Nephrology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $107