Remission of steroid- and CyA-resistant nephrotic syndrome using multiple drug immunosuppression
In: Pediatric Nephrology Pediatric Nephrology, Springer Verlag, 2007, 22 (10), pp.1723-6. ⟨10.1007/s00467-007-0551-x⟩; (2007-10-01)
Online
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Zugriff:
International audience; 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.
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Remission of steroid- and CyA-resistant nephrotic syndrome using multiple drug immunosuppression
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Autor/in / Beteiligte Person: | Bensman, Albert ; Guigonis, Vincent ; Deschênes, Georges ; Perrin, Laurence ; Ulinski, Tim ; Driss, Françoise ; Physiologie Moléculaire de la Réponse Immune et des Lymphoproliférations (PMRIL) ; Université de Limoges (UNILIM)-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Centre National de la Recherche Scientifique (CNRS) ; Service de néphrologie et pédiatrie générale [CHU Trousseau] ; Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU) |
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Quelle: | Pediatric Nephrology Pediatric Nephrology, Springer Verlag, 2007, 22 (10), pp.1723-6. ⟨10.1007/s00467-007-0551-x⟩; (2007-10-01) |
Veröffentlichung: | HAL CCSD, 2007 |
Medientyp: | unknown |
ISSN: | 0931-041X (print) ; 1432-198X (print) |
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