{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:18:44Z","timestamp":1790983124326,"version":"4.1.0"},"reference-count":20,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,6]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>Zebra bodies\u2014electron-dense lamellar lysosomal inclusions\u2014are the renal hallmark of Fabry disease, caused by deficient \u03b1-galactosidase A (GLA) activity. However, several pharmacological agents with cationic amphiphilic properties produce morphologically indistinguishable deposits, resulting in drug-induced phospholipidosis. We describe a woman in her 50s referred to nephrology with non-nephrotic proteinuria and non-visible haematuria following an ischaemic stroke treated with prednisolone and methotrexate for concomitant medium-vessel vasculitis. Aetiological workup\u2014including autoimmunity, anti-phospholipase A2 receptor and GLA gene sequencing\u2014was negative. Renal biopsy revealed lamellated myelin bodies in podocyte cytoplasm on electron microscopy, alongside thin basement membrane disease. Given negative Fabry testing and chronic sertraline exposure\u2014a selective serotonin reuptake inhibitor with known cationic amphiphilic properties\u2014the drug was discontinued. Proteinuria fell from 2.8\u2009g\/24\u2009hours to 0.13\u2009g\/24\u2009hours at 6\u2009months, with complete resolution of non-visible haematuria. This case underscores the importance of pharmacological review in Zebra body nephropathy.<\/jats:p>","DOI":"10.1136\/bcr-2026-274410","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T13:25:20Z","timestamp":1787232320000},"page":"e274410","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Sertraline-induced renal phospholipidosis"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9173-5845","authenticated-orcid":false,"given":"Filipa Fonte","family":"Rodrigues","sequence":"first","affiliation":[{"name":"Nephrology Department, Unidade Local de Sa\u00fade de Almada-Seixal, Almada, Set\u00fabal, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diogo","family":"Borges","sequence":"additional","affiliation":[{"name":"Nephrology Department, Unidade Local de Sa\u00fade de Almada-Seixal, Almada, Set\u00fabal, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Manso","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade de Amadora\/Sintra, Amadora, Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Barreto","sequence":"additional","affiliation":[{"name":"Nephrology Department, Unidade Local de Sa\u00fade de Almada-Seixal, Almada, Set\u00fabal, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"2026082006251181000_19.8.e274410.1","unstructured":"Mehta A , Hughes DA , et al . 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