Telitacicept for minimal change disease

Minimal change disease (MCD) is a common pathological type of idiopathic nephrotic syndrome. The first-line therapy is prednisone, but steroid-sensitive forms frequently relapse. Telitacicept, a B lymphocyte stimulator and a proliferation-inducing ligand dual inhibitor, has been investigated for several autoimmune diseases. A 44-year-old female presented with edema of both lower extremities for 20 days in July 2020. Urine protein was +++, 24-h urine protein was 5055 mg, and serum albumin was 25.5 g/L; other laboratory test results were unremarkable. The patient received Tripterygium wilfordii, irbesartan, and antihydropic diuretic agents for 2 months. The edema was not completely alleviated. Renal pathology showed no obvious pathological changes. Immunofluorescence revealed no obvious immunofluorescence distribution. Electron microscopy showed a diffuse foot process fusion of the podocytes,