I’m a 28 year old male with MCD. I was diagnosed with it back in 2010 through a kidney biopsy. After being treated with prednisone for about 6 months I was on my way to remission. Everything was fine until last spring. I went to the emergency department after loosing about 25lbs while dealing with what felt like a really bad cold. They thought it was pneumonia gave me antibiotics and sent me on my way. That didn’t work. My coughing worsened to the point that I couldn’t keep food down and was throwing up constantly. After about 4 months of seeing 3 specialists and 2 separate lung biopsy’s they concluded it was blastomycosis a fungil infection in my lungs. I’ve been on antifungil meds for almost 5 months. The problem is my MCD started to flair up again in all of this and my kidney specialist is at a loss as to what we can do. Now the fungus seems to be spreading and they won’t put me on steroids because they figure that will accelerate the spreading of the fungus. But I’m spilling about 15 grams a day of protein right now and they are getting very concerned. I was wondering if u had any recommendations. Maybe you could also explain what will happen if the protein levels continue to rise, they are very concerned but I don’t really understand how bad the situation is.

Minimal Change Disease (MCD) is a protein losing disease of the kidney that is commonly treated with prednisone.  It does tend to recur.  You have a very complex illness and I am not able to recommend medical treatment without performing a complete history and physical examination.  Since you are fighting a fungal infection, prednisone and other steroids are not a good choice.  Altering your immune system while you are fighting a fungal infection should be avoided.  Your kidney disease also causes the loss of important proteins used in fighting infection, so you have a very complex situation.  I recommend that you continue to work with your present physicians to guide your complex medical care.  

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