Resolution of Late Steroid-Responsive Nephrotic Syndrome in a Patient with Alport Syndrome Treated with Atorvastatin

Experimental and clinical studies have pointed out the lipid-induced renal damage, and statins may have pleiotropic effects on renoprotection. We reported a girl with X-linked Alport syndrome whose late steroid-responsive nephrotic syndrome (NS) was resolved by atorvastatin. She had been in a nephrotic condition despite of prednisone therapy 60 mg/day for 8 weeks. Renal biopsy dispicted extreme foamy appearance of tubular epithelial cells with detachment led to luminal obliteration. Atorvastatin was started on the ninth week of prednisone therapy due to severe hypercholesterolemia. Partial remission of NS was dramatically achieved with unchanged dosage of prednisone at the end of the twelfth week. Our case provides a pathology-based evidence to support the use of statins in profoundly hyperlipidemic patients with NS. In patients with NS and profound hyperlipidemia, early initiation of statin therapy is required in combination with immunosuppressive therapy.