case_images: PMC11317288_01
case_images: Clinical assessment and approach to treatment. The serum albumin level is indicated by the black curve. Proteinuria is evaluated using urine TPCR (blue curve). B cell counts are shown as a purple curve. The length of the gray vertical lines in the third panel corresponded to the prednisone dose. The length of the lines corresponded to the prednisone dose. The initial dose was 60 mg. The thick and thin arrows for rituximab indicate doses of 1 and 0.5 g, respectively.
case_images: fimmu-15-1407461-g001.jpg
case_images: PMC11317288_01_fimmu-15-1407461-g001.jpg
case_images: f1
case_images: Initial laboratory tests showed a serum albumin level of 23.3 g/L and a urine total protein-to-creatinine ratio (TPCR) of 13.2 g/g ( Figure 1 ).
case_images: Kidney biopsy findings indicate glomerular minimal change. One of the 25 glomeruli showed signs of global sclerosis on light microscopy. The remaining glomeruli appeared normal in terms of cellularity, capillary wall, mesangial matrix, and cells [(A), hematoxylin and eosin]. Masson staining did not reveal any fuchsinophilic deposits, and the structures of the arterioles appeared normal [(B), masson, original magnificationx200]. Immunofluorescence staining yielded negative results. Electron microscopy further revealed effacement of podocyte foot processes [(C), original magnificationx4000].
case_images: fimmu-15-1407461-g002.jpg
case_images: PMC11317288_01_fimmu-15-1407461-g002.jpg
case_images: f2
case_images: A renal biopsy was performed to confirm the presence of minimal change disease, as shown in  Figure 2 .