The combination of nephrotic syndrome with mild histopathological lesions of IgA nephropathy is considered by some as a special form of IgA nephropathy with superimposed minimal change disease (MCD) while by others as a coincidental deposition of IgA in patients with MCD (MCD-IgAN). We present the first case of complete remission of nephrotic syndrome in a 55-year-old man with MCD-IgAN after the administration of a targeted-release formulation of budesonide (TRF-budesonide). The patient’s treatment with TRF-budesonide, even though methylprednisolone, mycophenolate mofetil, and cyclophosphamide had been previously tried, is of particular importance because it not only suggests that TRF-budesonide appears to be a promising treatment for MCD-IgAN but may also provide a new therapeutic option for patients with podocytopathies.

1.
Barratt
J
,
Feehally
J
.
IgA nephropathy
.
J Am Soc Nephrol
.
2005
;
16
(
7
):
2088
97
.
2.
Sinnassamy
P
,
O’Regan
S
.
Mesangial IgA deposits with steroid responsive nephrotic syndrome: probable minimal lesion nephrosis
.
Am J Kidney Dis
.
1985
;
5
(
5
):
267
9
.
3.
Herlitz
LC
,
Bomback
AS
,
Stokes
MB
,
Radhakrishnan
J
,
D’Agati
VD
,
Markowitz
GS
.
IgA nephropathy with minimal change disease
.
Clin J Am Soc Nephrol
.
2014
;
9
(
6
):
1033
9
.
4.
Matsukura
H
,
Miya
K
,
Arai
M
,
Miyawaki
T
,
Inaba
S
.
Minimal change variants with mesangial IgA deposits
.
Clin Nephrol
.
2007
;
68
(
5
):
337
8
.
5.
Wang
J
,
Juan
C
,
Huang
Q
,
Zeng
C
,
Liu
Z
.
Corticosteroid therapy in IgA nephropathy with minimal change-like lesions: a single centre cohort study
.
Nephrol Dial Transpl
.
2013
;
28
(
9
):
2339
45
.
6.
Lai
KN
,
Lai
FM
,
Ho
CP
,
Chan
KW
.
Corticosteroid therapy in IgA nephropathy with nephrotic syndrome: a long term controlled trial
.
Clin Nephrol
.
1986
;
26
(
4
):
174
80
.
7.
Fellstrom
BC
,
Barratt
J
,
Cook
H
,
Coppo
R
,
Feehally
J
,
de Fijter
JW
, et al
.
Targeted-release budesonide versus placebo in patients with IgA nephropathy (NEFIGAN): a double-blind, randomised, placebo-controlled phase 2b trial
.
Lancet
.
2017
;
389
(
10084
):
2117
27
.
8.
Barratt
J
,
Lafayette
R
,
Kristensen
J
,
Stone
A
,
Cattran
D
,
Floege
J
, et al
.
Results from part A of the multi-center, double-blind, randomized, placebo-controlled NefIgArd trial, which evaluated targeted-release formulation of budesonide for the treatment of primary immunoglobulin A nephropathy
.
Kidney Int
.
2023
;
103
(
2
):
391
402
.
9.
Lafayette
R
,
Kristensen
J
,
Stone
A
,
Floege
J
,
Tesar
V
,
Trimarchi
H
, et al
.
Efficacy and safety of a targeted-release formulation of budesonide in patients with primary IgA nephropathy (NefIgArd): 2-year results from a randomised phase 3 trial
.
Lancet
.
2023
;
402
(
10405
):
859
70
.
10.
Li
XW
,
Cheng
SQ
,
Liang
SS
,
Le
WB
,
Zeng
CH
,
Wang
JQ
, et al
.
Comparison between patients with IgA nephropathy with minimal change disease and patients with minimal change disease
.
Clin Nephrol
.
2016
;
85
(
5
):
273
81
.
11.
Kim
SM
,
Moon
KC
,
Oh
KH
,
Joo
KW
,
Kim
YS
,
Ahn
C
, et al
.
Clinicopathologic characteristics of IgA nephropathy with steroid-responsive nephrotic syndrome
.
J Korean Med Sci
.
2009
;
24 Suppl
(
Suppl 1
):
S44
9
.
12.
Garcia Camin
RM
,
Cabezas
A
,
Calero
F
,
Ballarin
JA
.
Steroid-responsive nephrotic syndrome in IgA nephropathy
.
Nefrologia
.
2004
;
24
(
Suppl 3
):
68
71
.
13.
Cheng
IK
,
Chan
KW
,
Chan
MK
.
Mesangial IgA nephropathy with steroid-responsive nephrotic syndrome: disappearance of mesangial IgA deposits following steroid induced remission
.
Am J Kidney Dis
.
1989
;
14
(
5
):
361
4
.
14.
Dube
GK
,
Markowitz
GS
,
Radhakrishnan
J
,
Appel
GB
,
D’Agati
VD
.
Minimal change disease in systemic lupus erythematosus
.
Clin Nephrol
.
2002
;
57
(
2
):
120
6
.
15.
Guo
WY
,
Sun
LJ
,
Dong
HR
,
Wang
GQ
,
Xu
XY
,
Cheng
WR
, et al
.
Characterization of patients with IgA nephropathy with and without associated minimal change disease
.
Front Nephrol
.
2023
;
3
:
1105933
.
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