Refractory THSD7A membranous nephropathy with severe asthma related to eosinophilia .

We report a case of a 50-year-old Japanese man with a history of pediatric asthma diagnosed with nephrotic syndrome after 4 years of relapsing asthma with severe eosinophilia. Thrombospondin type-1 domain-containing 7A membranous nephropathy (THSD7A-MN) was diagnosed based on histological evaluation. We started a course of steroid semi-pulse therapy, high-dose oral prednisolone, mizoribine, and cyclosporine. Frequent relapse of asthma was observed after gradual tapering of prednisolone dose to 10 mg/day. After improvement of asthma symptoms and eosinophilia, his serum albumin level increased gradually. Considering the clinical course of refractory MN and asthma, we suggest that THSD7A-MN may be associated with severe asthma and eosinophilia.