If the patient is steroid resistant what are the treatment options for MCD?
The patient who is steroid resistant should have a kidney biopsy if one has not yet been performed.
The biopsy may show focal, segmental glomerulosclerosis; MCD; or membranous nephropathy. Treatment options include a course of high-dose intravenous methylprednisolone, oral cyclosporine, or tacrolimus. Mycophenolate mofetil may also be tried.
Some newer reports have shown some promise with rituximab, a CD20 monoclonal antibody, but those reports are still preliminary.
