A case of idiopathic nephrotic syndrome treated with the homeopathic therapeutic

Abstract

p class="IJHDRabstract" style="margin: 0cm 1cm 6pt;"> Nephrotic syndrome is a chronic clinical condition and drugs used in its treatment may result in severe side-effects. Renal transplantation or renal ablation and subsequent chronic dialysis treatment may be the only feasible way to patients. The present article reports the case of a 23-years-old white woman that presented nephrotic syndrome and was successfully treated with homeopathic medicines. Six kind of homeopathic diagnoses were made to build the clinical homeopathic picture of the patient and to determine the appropriate medicines, according to the clinical protocol used. Apis mellifica was the main medicine used to treat the diathesis sycosis. The satisfactory treatment outcome shows that the judicious homeopathic therapeutic may be a valuable resource in the treatment of nephrotic syndrome.

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Int J High Dilution Res 2009; 8(26):26-32
26
Case Report
A case of idiopathic nephrotic syndrome treated with
the homeopathic therapeutic
Luiz Figueira Pinto
Federal Rural University of Rio de Janeiro, RJ, Brazil
ABSTRACT
Nephrotic syndrome is a chronic clinical condition and drugs used in its treatment may result in
severe side-effects. Renal transplantation or renal ablation and subsequent chronic dialysis
treatment may be the only feasible way to patients. The present article reports the case of a 23-
years-old white woman that presented nephrotic syndrome and was successfully treated with
homeopathic medicines. Six kind of homeopathic diagnoses were made to build the clinical
homeopathic picture of the patient and to determine the appropriate medicines, according to the
clinical protocol used. Apis mellifica was the main medicine used to treat the diathesis sycosis.
The satisfactory treatment outcome shows that the judicious homeopathic therapeutic may be a
valuable resource in the treatment of nephrotic syndrome.
Keywords: Nephrotic syndrome; Clinical protocol; Diathesis; Sycosis; Homeopathy
Introduction
Nephrotic syndrome is a chronic clinical condition
characterized by proteinuria, hypoalbuminemia,
edema, and hypercholesterolemia. Edema is the
predominant feature, and in time it becomes
generalized and may be associated with the
increase in weight, development of ascitic or
pleural effusion, and decline in urine output. It is
more common in children than in adults [1, 2].
Drugs used in the treatment of nephrotic
syndrome include corticosteroids,
immunomodulators, immunosuppressant, diuretics
and antibiotics. The response to these drugs
depends on the cause of nephrotic syndrome. These
treatments may result in severe side-effects, and
there are some contraindications for their use [1, 2,
3]. Renal transplantation or renal ablation and
subsequent chronic dialysis treatment may be the
only feasible way to help patients that showed
resistance to the other treatments [4].
Complementary and alternative therapies are
increasingly been used in a variety of clinical
conditions with successful results [5, 6].
The present article reports the case of a 23-years-
old white woman that presented nephrotic
syndrome and was successfully treated with
homeopathic medicines.
Case report
The disease process started 29 months before the
first homeopathic attendance, with swelling of the
feet that evolved into ascites. Spontaneous
remission had occurred previously on two
occasions,. On that time, the idiopathic nephrotic
syndrome was diagnosed after biopsy (performed
at University Hospital Clementino Fraga Filho,
Federal University of Rio de Janeiro) and the
treatment was initiated in February 2003 and
finished in August 2004, including Prednisone
(20mg/day), Furosemide (40mg/day),
Hidroclorotiazide (25mg/day), Simvastatin
(20mg/day), Cyclophosphamide (50mg/day),
Captopril (12,5mg/ day), Levofloxacin
(500mg/day), Levamisole hydrochloride and
Vitamin A and D, at different times., without
clinical response. After a few months, renal
transplantation was recommended and the patient
was left without further treatment waiting for a
compatible donor. In the meanwhile, she sought
several complementary and alternative therapies,
including orthomolecular medicine, blood-group
diet and homeopathy, all equally unsuccessful.
This treatment was realized in another service and
occurred from October 2004 to April 2005. The
patient presented with failure labor since October

Int J High Dilution Res 2009; 8(26):26-32
27
2003 and received a disability retirement in
January 2005.
The first homeopathic attendance was in June
2005, the patient presented severe swelling in the
legs and ascites. She was overweight and her urine
was foamy. She was prostrated and would only
leave the bed or couch to go to the bathroom.
(Figure 1) At that time, she was not taking any
medicine. Her mother brought her to the
attendance compulsorily and she was irritated,
frightened and discouraged and did not bring the
results of the laboratory tests. She was very
frustrated and disappointed, and appeared to
refuse to remember her clinical history. Her
mother told me she had proteinuria,
hypoalbuminemia and hypercholesterolemia.
Figure 1: patient with swollen legs and ascites.
Significant antecedents included: menarche at 12
years old, and absence of menstrual periods for
more than six months; asthma since she was two
years old; measles at eight years old, occasional
tonsillitis and flu; and allergy to dipyrone. The
family history did not reveal significant data.
On physical examination were registered arterial
hypertension (160/100mmHg) , severe
swelling of the legs associated with increase in
weight (from 63 to 110 kg) and loss of muscular
mass in the arms; lumbar lordosis and felon on the
right halux. Her body was of regular aspect, the
angle between arm and forearm was 180
0
, and
costal-external angle was 90
0
.
Homeopathic approach was the one described by
Pinto [7] and the following diagnoses were
established: 1) Clinical: idiopathic nephrotic
syndrome; 2) Dynamic clinical prognosis: severely
lesional to incurable; 3) Biopathographic factors:
pathological personal history; 4) Biotypologic:
sulphuric; 5) Temperamental: atrabiliary; 6)
Diathesic: sycosis and tuberculinism.
Symptoms selected and repertory correlations are
described in Table 1. Repertory analysis was made
with a repertorial homeopathic system [8], and
results pointed out to Arsenicum album, Apis
mellifica, Mercurius solubilis, Lachesis muta, Kali
carbonicum, Calcarea ostrearum, Pulsatilla
nigricans, Lycopodium clavatum, China officinalis,
and Natrum muriaticum.
.
Table 1: Symptoms selected and repertory correlations
Clinical symptoms
Repertory rubrics
Anxiety for the future
Mind, anxiety future about
Weeps easily
Mind, weeping tearful mood
Jealousy
Mind, jealousy
Desire for company
Mind, company desire alone aggravation
Ailments from bad news
Mind, ailments bad news
Sadness
Mind, sadness depression
Swollen abdomen
Abdomen, hidropsy, ascites
Swollen legs
Extremities, swelling hydropsical edematous
Albuminuria
Extremities, swelling lower limbs hydropsical
albuminúria in
Felon
Extremities, felon panaritium
Swelling in general
Generalities, swelling general in
Anemia
Generalities, anemia

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Table 2: Clinical progress and management
[AC: abdominal circunference (cm); BP: blood-pressure (mmHg)]
Date
Clinical Evolution
Physical examination
Prescription
06/08/05
After visiting the psychologist,
she felt worst; had nightmares
involving doctors. Sleep and
bowels motions improved; urine
less foamy. More frightened and
discouraged.
Swollen legs and face;
pale conjunctivae.
AC: 130; BP: 120/90
Natrum sulphuricum
(Nat-s) 6cH at
morning + Kidney 6cH
at night, once daily.
06/15/05
Can stretch her legs; still
irritated and frightened.
Face no longer swollen;
pale conjunctivae; AC:
123; BP: 140/90
The same.
06/22/05
Anguished due to inflammation
and perspiration on right leg.
Has discontinued homeopathy
and took diuretics for two days
without improvement.
Swollen legs and ascites;
pale conjunctivae; AC:
123; BP: 140/100
Tuberculinum of Koch
(TK) 30cH at morning
+
Berberis vulgaris
(Berb-v) 6cH at night,
once daily.
07/06/05
Frequent and copious urination;
better appetite; thinner;
perspiration on right leg.
Brought laboratory exams.
Swollen legs and ascites;
pale conjunctivae;
proteinuria: +++;
BP: 140/90.
The same.
07/20/05
Feeling better; can use the
shower standing; abdomen is
softer; frequent and copious
urination; cramps in feet.
Swollen legs and ascites;
pale conjunctivae; AC:
130; BP: 150/100
Kidney 6cH, once daily.
08/03/05
Asthma crisis with fear of death.
Swollen legs and ascites;
adenopathy on left side of
the neck.
Adrenal 6cH + Kidney
6cH + Berb-v 6cH +
TK 30cH + Iodium 6cH
+, once daily.
08/12/05
Discouraged; cannot watch TV
nor read magazines for religious
reasons.
Swollen legs and ascites;
pale conjunctivae; BP:
140/90; Weight: 110kg
Nat-s 6cH + Kidney
6cH twice a day.
Asked urine exam.
08/22/05
Right leg inflamed and
perspiring; frightened but
hopeful. Did not make urine
exam.
Vesicular eruption on
right leg (Figure 2); pale
conjunctivae; proteinuria:
+ ; BP: 140/90; Weight:
102kg.
Nat-s 6ch + Kidney
6cH once daily.
09/16/05
Can lie on abdomen; stands up
quickly. Has been eating many
eggs and mayonnaise.
Quick responses; pale
conjunctivae; lumbar
lordosis and legs swelling
diminished; BP: 150/90
Nat-s 6cH + Cortisone
6cH at 8 a.m. and 6
p.m.
10/14/05
Anxiety about her health; hopes
to be well by Christmas.
Scabs on right leg; full-
blooded lips and
Cortisone 6cH at 8 a.m.
and 6 p.m. + Adrenal

Int J High Dilution Res 2009; 8(26):26-32
29
conjunctivae; neck
adenopathy healed;
recovery of muscular
mass in arms; BP: 140/90;
Weight: 103kg
6cH at 8 a.m. +
Nat-s 6cH at 6 p.m. +
Apis 6cH at night.
Asked lab exams.
10/22/05
Home call: intense headache and
fear of death.
Very anxious; weight:
98kg
Magnesia sulphurica
(Mag-s) 6cH twice a
day.
10/24/05
After headache, asthma crisis;
she attributed it to the exposure
to draft after showering.
Dyspnea and wheezing;
Proteinuria: ++.
Arsenicum album (Ars-
a) 6cH, nebulization 3
times daily
11/09/05
Frightened due to headache
after a row with her brother.
BP: 140/100; weight: 92kg
Mag-s 6cH, twice a
day.
11/14/05
After headache, severe
abdominal pain and diarrhea,
asked her parents to hold her
belly.
BP: 110/70; weight: 90kg
Apis 6cH, once daily.
12/7/05
Physically better but
psychologically unwell; very
needy of her parents;
complaining and waiting for
Christmas.
BP: 120/80; weight: 84kg
The same.
12/28/05
Well at Christmas, but angry
about the previous weekend.
BP: 120/80; weight: 74kg
The same.
01/11/06
Well at New Year’s party; urine
is still foamy.
Legs are thin and
wrinkled; BP: 140/80;
weight: 65kg
Apis 30cH once daily.
Lab exams requested.
01/26/06
Angry and weak; headache
extending to face and eyes,
worse on the right side. Has not
made lab exams requested.
BP: 120/70; weight: 59kg
The same.
02/15/06
Toothache extending to the right
side of the body and diplopia;
frightened.
3
rd
molar inflamed, facial
sensitiveness, right
horizontal strabismus
(Figure 3). Lab
tests:hypoalbuminemia:
1.2 g/dL; proteinuria:
+++; BP: 140/80; weight:
58kg
Arnica 6cH + Silicia
6cH + Calc-p 6cH +
Calc-f 6cH, once daily.
03/01/06
03/15/06
Feeling well despite the
toothache and diplopia.
BP: 140/90; weight: 57kg
The same + Adrenal
6cH. Urine exam
requested.
04/15/06
At her birthday party overate
until feeling ill. Urine is still
foamy.
Urine exam: proteinuria
(++). Weight: 53kg
Apis 6cH +
Nat-s 6cH,
Once daily.
05/17/06
“She’s again who she was”, said
her mother. Very happy, lust for
life. Menstruation came back.
Weight: 58kg
Without medication.

Int J High Dilution Res 2009; 8(26):26-32
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07/12/06
Toothache.
Magnesia carbonica
6cH + Arnica 6cH +
Silicia 6cH + Calc-p
6cH + Calc-f 6cH,
once daily.
08/09/06
Menstruated in July and
August, with swelling and
unwell.
Apis 6cH once daily.
10/18/06
No clinical complaints (Figure 4).
BP: 120/80; weight: 65kg
Discharge.
Based on the diagnoses established, it was
prescribed Apis mellifica 6cH and Berberis
vulgaris 6cH once daily. Clinical progress and
management are described in Table 2. All
medicines were taken in the dosage of five tablets.
Figure 2: patient with vesicular eruption on right
leg.
Figure 3: patient with right horizontal
strabismus.
Figure 4: patient after treatment.
Discussion
The patient had a clinical diagnosis of idiopathic
nephrotic syndrome based on the laboratory
findings of anemia and albuminuria and focal
segmental glomerulosclerosis, which is the most
common form of glomerulopathy causing nephrotic
syndrome in adults [1,2], and determines a poor
prognosis [9]
Six diagnoses were made to build the clinical
homeopathic picture of the patient and to
determine the adequate medicines to be
prescribed, according to clinical protocol employed
[7].
Regarding biopathographic aspects, the patient
had a history of chronic dynamic diseases, possibly
sycosis (measles, tonsillitis and flu), tuberculinism
(asthma), and psora (allergies) [7, 10, 11].

Int J High Dilution Res 2009; 8(26):26-32
31
Nephrotic syndrome was classified as sycosis and
was prescribed Apis mellifica 6cH and Berberis
vulgaris 6cH to promote kidney stimulation. This
procedure resulted in clinical aggravation,
according to first or second Kent`s prognosis [12],
recorded by increasing the swelling of the face and
extremities, and worsening of the psyche.
Therefore, the diathesic medicine was interrupted
and administered the constitutional (Natrum
sulphuricum 6cH) and the biotherapic (Kidney
6cH, Adrenal 6cH and Cortisone 6cH) medicines at
different times. This procedure can be performed
when there are serious organ dysfunctions [7].
As the patient did not improve, and based on her
personal history and the occurrence of asthma and
adenopathy, the presence of tuberculinism was
considered. . In these cases, when dissimilar
diseases occur [13], it is necessary to treat the
dominant chronic disease first [7, 10]. Thus,
Tuberculinum of Koch 30cH, Iodium 6cH and
Arsenicum album 6cH were prescribed at different
times. After this, the clinical improvement started
to be shown by weight loss, full-blooded lips and
conjunctivae, and recovery of muscular mass in
arms.
Despite the clinical evolution, swollen legs, ascites
and albuminuria remained. Therefore, was
prescribed Apis mellifica (6cH and 30cH) to finish
the sycosis treatment. Consequently, the
resumption of growth of the mandibular third
molar tooth, the recovery of body weight and
muscular mass in arms, and the return of the
menstrual flow were observed, characterizing the
recovery of the sanguine temperament which
corresponds to the biological age of the patient [7].
The growth of the mandibular third molar tooth
caused an inflammatory process adjacent to the
trigeminal nerve root that resulted in toothache,
headache and strabismus. These clinical
manifestations were treated with circumstantial
medicines [14].
Remission or relapse of nephrotic syndrome can
happens after corticosteroids and cytotoxic drugs
treatment [15]. Nevertheless, this patient showed
the most common change renal (membranous
glomerulonephritis) after two spontaneous
remission and no responded to conventional
treatment. In spite of her poor prognosis the
clinical remission occurred after judicious
homeopathic treatment and there was no relapse
during the 28-month follow-up. Similarly, in a case
reported about the homeopathic treatment of
vaginal leiomyoma in a dog, considered clinically
incurable, in which the same clinical protocol was
used, the clinical remission was also demonstrated
[16]. The fact that this protocol has been described
in veterinary medicine means that it is an
objective method whose results were destitute of
placebo effect. This makes it reliable to be used in
humans patients.
Conclusions
Nephrotic syndrome is a chronic dynamic disease
which requires specific treatment to the diathesis
sycosis.
The satisfactory outcome in this case shows that
the judicious homeopathic therapeutic may be a
valuable resource in the treatment of nephrotic
syndrome.
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Licensed to GIRI
Support: authors declare that this study received no funding
Conflict of interest: authors declare there is no conflict of interest
Received: 27 Aug 2008; Revised 12 Feb 2009; Published: 31 Mar 2009
Correspondence author: Luiz Figueira Pinto, luizfigueira@ufrrj.br
How to cite this article: Pinto LF. A case of idiopathic nephrotic syndrome treated with the homeopathic therapeutic. Int J
High Dilution Res [online]. 2009 [cited YYYY Mmm dd]; 8(26):26-32. Available from:
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