I know Dr Engelman from the early days of clinical trials with captopril; I thank him for his remarks. I will not dispute his experience with captopril and proteinuria; however, to the best of my knowledge, these cases have not been published and therefore cannot be critically evaluated.
My letter1 concerned the listing of captopril as a "major" cause of nephrotic syndrome in the otherwise superb review by Madaio and Harrington.2 I asked Dr Madaio if he had new information bearing on this issue; he did not. I therefore pointed out that captopril was by no means a major cause of nephrotic syndrome. I then questioned whether it was ever a cause at all. It is this latter statement that troubles Dr Engelman.
Materson BJ. Is There Proof That Captopril Causes Proteinuria?—Reply. Arch Intern Med. 2002;162(7):842-843. doi: