Tumor necrosis factor-alpha blocking agent as a treatment for nephrotic syndrome.

We report a 13-year-old boy with refractory nephrotic syndrome (minimal change with mesangial proliferation) who failed the standard treatment protocols. There was some temporary response to large steroid doses, but even the Mendoza protocol could not induce remission. We show suppression of the proteinuria with Infliximab (Remicade) with tapering of steroids. Serial serum levels of tumor necrosis factor (TNF)-alpha are shown and discussed. We suggest studying the TNF-alpha blocking agents as optional treatment for nephrotic syndrome.