RESPONSE TO METHOTREXATE IN A PATIENT WITH IDIOPATHIC EOSINOPHILIC FASCIITIS, MORPHEA, IGM HYPERGAMMAGLOBULINEMIA, AND RENAL INVOLVEMENT

A 35-year-old man with idiopathic eosinophilic fasciitis (EF) and morp hea developed renal disease characterized by microscopic hematuria, ne phrotic range proteinuria, and rapidly progressing hypertension, an as sociation that has not previously been reported in EF. Initial clinica l symptoms of EF began in July 1989; peripheral eosinophilia peaked at 30% in August 1990; an abnormal urinalysis was first observed in Marc h 1992 and subsequently a renal biopsy was performed. Renal biopsy dem onstrated focal segmental glomerulosclerosis and a subepithelial immun e-type deposit. Partial fasciectomy and a course of methotrexate resul ted in overall functional improvement of his extremities. Proteinuria and hematuria was reduced during methotrexate therapy.