Figure 2.

The clinical course after the diagnosis of secondary membranous nephropathy concurrent with IgG4-related tubulointerstitial nephritis. Although urinary NAG decreased promptly with the increase in the PSL dose, the proteinuria persisted even after combination treatment with mizoribine and IVCY. After the coadministration of CyA with PSL, the urinary protein excretion gradually decreased, and complete remission was achieved at 21 months of follow-up. Although the serum IgG4 level had been re-elevated by PSL tapering, the proteinuria was sufficiently suppressed. NAG: N-acetyl-β-D-glucosaminidase, PSL: prednisolone, MZR: mizoribine, IVCY: intravenous cyclophosphamide, CyA: cyclosporine