{"title":"一例弗雷泽综合征获得完全缓解环孢素A类固醇抵抗性肾病综合征。","authors":"Yasuhiro Inaba, Akinori Miyazono, Takuro Mitsunobu, Yuko Seki, Kandai Nozu, China Nagano, Yasuhiro Okamoto","doi":"10.1007/s13730-025-01018-w","DOIUrl":null,"url":null,"abstract":"<p><p>In pediatric steroid-resistant nephrotic syndrome (SRNS), causative genetic abnormalities are now being identified. Immunosuppressive therapy is generally believed to be ineffective in treating Frasier syndrome, which is associated with genetic abnormalities. Recently, the efficacy of cyclosporine A (CyA) via a non-immunological mechanism has been reported. However, all of these reports have shown partial remission. In the present study, we report a case of nephrotic syndrome in a 1-year-old patient who was treated with CyA for SRNS. Complete remission was confirmed for 6 months, and the patient is currently in partial remission. Following confirmation of complete remission, hereditary nephrotic syndrome was not actively investigated; however, delayed secondary sexual characteristics' development led to the diagnosis of Frasier syndrome at the age of 13 years. Thus, immunosuppressive agents may have some efficacy in treating Frasier syndrome, particularly given that our patient achieved complete remission, indicating that it is worth considering administration of immunosuppressive agents for Frasier syndrome management.</p>","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":" ","pages":""},"PeriodicalIF":0.7000,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A case of Frasier syndrome achieved complete remission by cyclosporine A for steroid-resistant nephrotic syndrome.\",\"authors\":\"Yasuhiro Inaba, Akinori Miyazono, Takuro Mitsunobu, Yuko Seki, Kandai Nozu, China Nagano, Yasuhiro Okamoto\",\"doi\":\"10.1007/s13730-025-01018-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>In pediatric steroid-resistant nephrotic syndrome (SRNS), causative genetic abnormalities are now being identified. Immunosuppressive therapy is generally believed to be ineffective in treating Frasier syndrome, which is associated with genetic abnormalities. Recently, the efficacy of cyclosporine A (CyA) via a non-immunological mechanism has been reported. However, all of these reports have shown partial remission. In the present study, we report a case of nephrotic syndrome in a 1-year-old patient who was treated with CyA for SRNS. Complete remission was confirmed for 6 months, and the patient is currently in partial remission. Following confirmation of complete remission, hereditary nephrotic syndrome was not actively investigated; however, delayed secondary sexual characteristics' development led to the diagnosis of Frasier syndrome at the age of 13 years. Thus, immunosuppressive agents may have some efficacy in treating Frasier syndrome, particularly given that our patient achieved complete remission, indicating that it is worth considering administration of immunosuppressive agents for Frasier syndrome management.</p>\",\"PeriodicalId\":9697,\"journal\":{\"name\":\"CEN Case Reports\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.7000,\"publicationDate\":\"2025-08-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"CEN Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s13730-025-01018-w\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"CEN Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s13730-025-01018-w","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
在儿童类固醇抵抗性肾病综合征(SRNS)中,现在正在确定致病遗传异常。免疫抑制疗法通常被认为是无效的治疗弗雷泽综合征,这是与遗传异常有关。近年来,环孢素A (cyclosporine A, CyA)通过非免疫机制发挥作用的报道越来越多。然而,所有这些报告都显示部分缓解。在本研究中,我们报告了一例1岁的肾病综合征患者,他接受了CyA治疗SRNS。6个月后确诊完全缓解,目前患者部分缓解。在确认完全缓解后,没有积极调查遗传性肾病综合征;然而,由于第二性征发育迟缓,在13岁时被诊断为弗雷泽综合症。因此,免疫抑制剂可能对治疗弗雷泽综合征有一定的疗效,特别是考虑到我们的患者完全缓解,这表明值得考虑使用免疫抑制剂治疗弗雷泽综合征。
A case of Frasier syndrome achieved complete remission by cyclosporine A for steroid-resistant nephrotic syndrome.
In pediatric steroid-resistant nephrotic syndrome (SRNS), causative genetic abnormalities are now being identified. Immunosuppressive therapy is generally believed to be ineffective in treating Frasier syndrome, which is associated with genetic abnormalities. Recently, the efficacy of cyclosporine A (CyA) via a non-immunological mechanism has been reported. However, all of these reports have shown partial remission. In the present study, we report a case of nephrotic syndrome in a 1-year-old patient who was treated with CyA for SRNS. Complete remission was confirmed for 6 months, and the patient is currently in partial remission. Following confirmation of complete remission, hereditary nephrotic syndrome was not actively investigated; however, delayed secondary sexual characteristics' development led to the diagnosis of Frasier syndrome at the age of 13 years. Thus, immunosuppressive agents may have some efficacy in treating Frasier syndrome, particularly given that our patient achieved complete remission, indicating that it is worth considering administration of immunosuppressive agents for Frasier syndrome management.
期刊介绍:
Clinical and Experimental Nephrology (CEN) Case Reports is a peer-reviewed online-only journal, officially published biannually by the Japanese Society of Nephrology (JSN). The journal publishes original case reports in nephrology and related areas. The purpose of CEN Case Reports is to provide clinicians and researchers with a forum in which to disseminate their personal experience to a wide readership and to review interesting cases encountered by colleagues all over the world, from whom contributions are welcomed.