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Authors from the University of Colorado describe a 31-year-old white female with tuberous sclerosis complex who was diagnosed with very large bilateral angiomyolipoma of the kidneys after developing symptoms of urinary tract infection and septic shock. The lack of surveillance throughout the course of the patient's disease prevented early intervention before the development of end-stage renal disease and the need for bilateral nephrectomy. This case illustrates the importance of regular follow-up in patients with tuberous sclerosis complex.
Mycophenolate mofetil (MMF) has been used successfully as an immunosuppressive medication in transplantation for over a decade. Because of its efficacy and relatively benign adverse effect profile, MMF's use has been investigated in the treatment of a number of glomerular diseases. This Review focuses on the major trials of MMF in lupus nephritis and other primary glomerulopathies including minimal-change disease, focal segmental glomerulosclerosis, membranous nephropathy and IgA nephropathy.