Document Detail


Therapy of focal and segmental glomerulosclerosis with methylprednisolone, cyclosporine A, and prednisone.
MedLine Citation:
PMID:  9686959     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients with steroid-resistant focal and segmental glomerulosclerosis (FSGS) have a poor prognosis but may benefit from high-dose methylprednisolone or cyclosporine A therapy. Ten patients were treated with a protocol of methylprednisolone infusions for 8 weeks followed by a combination of cyclosporine A and alternate-day prednisone for maintenance of remission for 2 weeks. Eight of ten patients remitted the nephrotic syndrome within 8 weeks of beginning treatment. One patient remitted edema but remained proteinuric, and one did not respond. After observation for 12-24 months, seven patients maintained remission with normal glomerular filtration rate. One non-responder had renal insufficiency and one patient had secondary non-response and end-stage renal disease. No patients developed hypertension. One patient had the diagnosis of Hodgkin disease made after 10 months of therapy. Follow-up renal biopsy in four patients showed no evidence of progressive interstitial disease. There were no other major side effects. Steroid-resistant FSGS may be successfully treated with the described protocol. Additional studies will be needed to determine if this approach prevents progression of renal disease.
Authors:
F B Waldo; M R Benfield; E C Kohaut
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric nephrology (Berlin, Germany)     Volume:  12     ISSN:  0931-041X     ISO Abbreviation:  Pediatr. Nephrol.     Publication Date:  1998 Jun 
Date Detail:
Created Date:  1998-10-02     Completed Date:  1998-10-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8708728     Medline TA:  Pediatr Nephrol     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  397-400     Citation Subset:  IM    
Affiliation:
University of Alabama at Birmingham, Department of Pediatrics, Children's Hospital, 35233, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Anti-Inflammatory Agents / administration & dosage*
Child
Child, Preschool
Cyclosporine / administration & dosage*
Drug Therapy, Combination
Female
Glomerulosclerosis, Focal Segmental / drug therapy*
Humans
Immunosuppressive Agents / administration & dosage*
Infusions, Intravenous
Male
Methylprednisolone / administration & dosage*
Prednisone / administration & dosage*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Immunosuppressive Agents; 53-03-2/Prednisone; 59865-13-3/Cyclosporine; 83-43-2/Methylprednisolone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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