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A Steroid-Responsive Nephrotic Syndrome in a Patient with Human Immunodeficiency Virus (HIV) Infection

Richard G. Appel, MD; and James Neill, MD
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Requests for Reprints: Richard G. Appel, MD, Department of Medicine, Bowman Gray School of Medicine, 300 South Hawthorne Road, Winston-Salem, NC 27103.

Current Author Addresses: Dr. Appel: Department of Medicine, Bowman Gray School of Medicine, 300 South Hawthorne Road, WinstonSalem, NC 27103.

Dr. Neill: Department of Clinical Pathology and Diagnostic Medicine, School of Medicine, East Carolina University, Greenville, NC 27858.

Ann Intern Med. 1990;113(11):892-893. doi:10.7326/0003-4819-113-11-892
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Patients with human immunodeficiency virus (HIV) seropositivity may present with various renal abnormalities, including minimal, focal, or diffuse glomerular mesangial proliferation (1-3). In addition, they may present with the "HIV-associated nephropathy" syndrome, which is characterized by a rapid progression to end-stage renal disease (4-7). We provide evidence that therapeutic intervention is appropriate in some settings.

Case Report: A 37-year-old white man developed generalized lymphadenopathy in August 1988. A lymph node biopsy revealed benign reactive hyperplasia. Urinalysis revealed 4+ protein by dipstick. In September 1988, the patient was admitted with dyspnea associated with increasing fluid accumulation. He denied intravenous drug use,


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