[Nephrotic syndrome in Crohn's disease].

Background: The differential diagnosis of nephrotic syndrome is diverse. Systemic conditions and medication such as NSAIDs can cause this syndrome.

Case Description: A 33-year-old male with Crohn's disease for which he was receiving adalimumab noticed he was gaining weight and had swollen ankles. Examination revealed nephrotic syndrome without renal insufficiency. Renal biopsy showed a membranous glomerulopathy. We excluded secondary causes of membranous glomerulopathy such as diabetes mellitus, systemic lupus erythematosus, viral infection or malignancy. We treated the patient with high-dose glucocorticoids on a weaning schedule and adalimumab was discontinued. This regimen resulted in complete remission. It is likely that the nephrotic syndrome with membranous glomerulopathy was associated with adalimumab.

Conclusion: In patients with nephrotic syndrome based on membranous glomerulopathy both primary and secondary causes, such as use of medication, need to be excluded.