Remission of steroid- and CyA-resistant nephrotic syndrome using multiple drug immunosuppression.
In: Pediatric nephrology (Berlin, Germany), Jg. 22 (2007-10-01), Heft 10, S. 1723-6
Online
academicJournal
Zugriff:
Nephrotic proteinuria in minimal change disease (MCD) is supposed to be due to a circulating factor of immunologic origin. End-stage renal failure occurs if both steroids and immunosuppressive drugs remain ineffective. Three children (2 years, 3 years, and 6 years of age) with secondary steroid-resistant nephrotic syndrome (NS) were included, as they remained resistant to 30 days of treatment with prednisone (60 mg/m(2) per day), three pulses of methylprednisolone (1 g/1.73 m(2)) followed by oral administration of CyA 7.5 mg/kg per day over 2 months, and 1 month of intravenous (i.v.) administration of cyclosporine (blood level 500-600 ng/ml). All three patients were partially responsive to methylprednisolone pulses, with an increase of serum albumin by 100%. They were treated with plasma exchanges, cyclophosphamide and cyclosporine A, both given orally, pefloxacin and methylprednisolone pulses followed by orally administered prednisone. All three patients went into remission within 2 to 5 weeks. The character of their NS changed to a steroid-sensitive one. There were no significant side effects from the therapy. They had normal renal function, normal blood pressure and no residual proteinuria. A combination of plasmapheresis and multiple immunosuppressive medications was effective in producing remission of minimal change NS in three children who were previously resistant to glucocorticoids and cyclosporine.
Titel: |
Remission of steroid- and CyA-resistant nephrotic syndrome using multiple drug immunosuppression.
|
---|---|
Autor/in / Beteiligte Person: | Ulinski, T ; Perrin, L ; Guigonis, V ; Driss, F ; Deschênes, G ; Bensman, A |
Link: | |
Zeitschrift: | Pediatric nephrology (Berlin, Germany), Jg. 22 (2007-10-01), Heft 10, S. 1723-6 |
Veröffentlichung: | Berlin : Springer International ; <i>Original Publication</i>: Berlin : Springer International, c1987-, 2007 |
Medientyp: | academicJournal |
ISSN: | 0931-041X (print) |
DOI: | 10.1007/s00467-007-0551-x |
Schlagwort: |
|
Sonstiges: |
|