A case of adrenal insufficiency after initiation of targeted-release budesonide formulation (Nefecon) in a patient with IgA nephropathy
Abstract
We describe a case of immunoglobulin A nephropathy (IgAN) treated with targeted-release budesonide (Nefecon) that resulted in notable systemic adverse effects. The patient developed cushingoid features, weight gain, hyperglycaemia and leucocytosis within 3 months of therapy. During dose tapering he experienced symptomatic adrenal insufficiency confirmed by low morning cortisol, requiring hydrocortisone replacement. Despite Nefecon's design for terminal ileum absorption, and hence assumed minimal systemic exposure, this case demonstrates clinically significant adverse effects and adrenal suppression. These findings underscore the need for careful monitoring and patient education when initiating and tapering Nefecon in IgAN management.
Fields of Study & Subjects
Renal Diseases and Glomerulopathies
Adrenal Hormones and Disorders
Renal Transplantation Outcomes and Treatments
Publication details
- Journal / source
- Clinical Kidney Journal
- Publisher
- Oxford University Press (OUP)
- Volume
- 19
- Issue
- 4
- Pages
- sfag037–sfag037
- Publication date
- 25 February 2026
- Language
- EN