Dual Remission of Atopic Dermatitis and Frequently Relapsing Nephrotic Syndrome With Dupilumab.
Inès Dastrevigne, Joëlle Terzic, Dan Lipsker et al.
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Case in brief
A 9-year-old girl had atopic dermatitis and frequently relapsing, steroid-sensitive nephrotic syndrome, with relapses increasing despite treatment with two immunosuppressants. Dupilumab 300 mg every 2 weeks was started in the context of her broad atopic phenotype. Her skin lesions cleared rapidly and completely, and nephrotic syndrome entered sustained complete remission for nearly 2 years. Corticosteroids and tacrolimus were discontinued within 2 months of starting dupilumab, with neither condition subsequently relapsing.
What made this case unusual
Both atopic dermatitis and frequently relapsing nephrotic syndrome remained in remission after dupilumab initiation, allowing discontinuation of corticosteroids and tacrolimus.
Diagnostic / clinical pearl
In a child with atopic dermatitis and frequently relapsing steroid-sensitive nephrotic syndrome, the shared type 2 inflammatory context may inform consideration of dupilumab as a steroid-sparing option; this report describes one patient.