A case of nephrotic syndrome showing collaptic glomeruli and tubulointerstitial changes

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We experienced a 10-year-old boy with steroid-resistant nephrotic syndrome accompanied with collaptic glomeruli and tubulointerstitial change such as tubules filled with urinary casts, interstitial fibrosis and inflammatory cells in interstitium. In the beginning, it was greatly difficult to wean this patient from full dosage of prednisolone. The introduction of cyclosporine treatment enabled maintaining the remission and weaning steroid. The second renal biopsy was performed one year after combination therapy including cyclosporine treatment, which revealed no remarkable findings. The patient was finally diagnosed with minimal change nephrotic syndrome based on these results, and then prednisolone was stopped. To date, the single use of cyclosporine has been successfully keeping the remission.